AcademyHealth Issue Brief: A Burning Platform and Trust

Key Ingredients for Payment Reform

A group of Robert Wood Johnson Foundation grantees aiming to advance innovative methods of health care payment gathered in June 2013 to learn from experts and from one another about their experiences experimenting with payment reform.

While the grantees’ initiatives varied widely, some trends emerged. First, when there is a burning platform to motivate action through fear, payment reform initiatives saw greater progress. Second, a strong trust between parties allows people to work together in the face of uncertainty. Initiatives that could boast one or both of these factors tended to do better in the communities.

This brief explores these concepts to understand how to facilitate movement toward fundamentally different payment and delivery models than those that have dominated American health care until now. Those with a desire to effect change should consider how they might adopt the suggested actions within this brief to help propel their initiatives forward.

The Robert Wood Johnson Foundation supports several grants testing health care payment reforms, some of which are managed by AcademyHealth.