Creating a ‘Healthier’ Health System: How Hard Could It Be?

Over my 30-plus years working in the healthcare environment, I’ve witnessed many evidence-based and well-intended attempts to “heal” our imperfect system for providing healthcare on national, regional, and local levels. When I was on the Board of Trustees of what was then called Catholic Healthcare Partners (now Mercy Health) in Ohio, Brent Asplin, MD, MPH, was the enterprise’s chief medical officer. Together, we helped steer that system’s transformative move into population health. The process entailed adopting new payment models and governance structures along with programs for physician engagement, care coordination, and chronic disease management.

Asplin is no stranger to the complex challenges of implementing change in the health care environment, so when he told me about an opportunity to “get inside the tent” of a still-evolving plan to develop and launch a new model for healthcare delivery and financing, my curiosity was piqued.

This nascent endeavor is called Foundation|42. The brains and the passion behind it is Jon Gordon, a successful venture capitalist and nationally known business consultant. Taking his inspiration from thriving mega-business models, he strongly believes he knows how to fix what’s broken in the U.S. healthcare system.

This is a fascinating work in progress. At Gordon’s invitation, I sat in on a few early-stage Zoom discussions among a variety of national stakeholders. The resulting report re: characteristics of an optimal healthcare model was spot-on but without any new “aha!” observations. In terms of model design, the initial findings suggested:

• Transitioning from system-centered to person-centered orientation
• Considering the “whole person” over a lifetime
• Shifting from sick care to health care
• Making healthcare equitable and easy to access and use for all persons
• Taking a long-term perspective on relationships and investments (e.g., optimization of outcomes that people value, investment in sustainability and well-being of the workforce, capabilities for anticipating, responding, and adapting to public health crises)
• Fostering a culture of continuous improvement
• Increasing the value of current spending before seeking to reduce costs

So far, so good. I don’t know anyone who would disagree. Now comes the hard part: building and promoting a new model that will succeed where so many other well-intended and carefully constructed models have failed (or inadvertently created more problems).

Gordon sees things from a different perspective than most. He sees a current healthcare economic model that hasn’t kept pace with advances in medicine, technology, or expectations of the healthcare system; and, he views the immediate problem as one of prioritizing an obsolete financing model over the needs of patients and clinical practitioners.

He believes that mission-oriented Foundation|42 has the ability to maximize impact on system transformation through its new approach. In very basic terms, the three-stage approach is as follows:

Design: Create a new model by envisioning what healthcare should be without the constraints of the current system.

Deploy: Substantiate and refine the model through targeted deployments with aligned partners.

Foster: Cohere outputs into an overarching model, offer open-source learnings, and cultivate an open innovation ecosystem.

Work is well underway for the design stage. To date, more than 150 healthcare leaders have participated in conversations around validating the thesis and approach, and engaged in the initial design process.

Could this savvy new approach succeed where others have failed? If we were starting from scratch, I would say “yes”. It has many of the essential elements for success, such as calm, comprehensive consideration of all aspects and data-driven perspectives.

As one familiar with the Herculean effort required to implement even a small change in a single sphere, I have my doubts. But for someone with Gordon’s unflagging determination, skills, and influential connections, the odds are more favorable.