Study on engaging consumers in health care governance

Despite Robust Commitment, Barriers Exist with Consumer Participation at the Highest Organizational Level

WASHINGTON (Jan. 25, 2018) – A new study by The Health Care Transformation Task Force (HCTTF) reveals that while consumer engagement is important at every-level of value based care delivery, providers are struggling to recruit, train and actively involve consumers in organizational governance.

The study brief highlights that the transition to value-based care delivery has increased momentum for implementing high-quality, patient-centered care and created demand for higher levels of effective consumer engagement.

“This research shows that many forms of consumer engagement are taking place at levels above and beyond a patient’s immediate care, but the implementation of the highest levels of engagement remains a balancing act with other aspects of a provider’s business strategy,” said Jeff Micklos, HCTTF’s Executive Director.

“The goal to fully engage patients as meaningful partners in design, implementation and governance of value models is well accepted.  Yet, the practical challenges of achieving that goal are significant, especially in the context of the usual ways of doing business.” said Susan Sherry, Deputy Director at Community Catalyst.  “All stakeholders must commit to working together to find new ways to make this vision a reality across the country.”

The study looked at consumer engagement structures and mechanisms utilized by provider organizations in the design and governance of value-based payment programs. The Task Force interviewed senior decisions-makers involved in consumer-engagement related activities and efforts at 13 organizations including nine integrated delivery systems, two physician groups/networks, one federally qualified health center, and one accountable care organization.

Participants reported a wide range of structures currently in place for engaging consumers as partners in governance and system design efforts, with 91.7% of participants reporting an increase in the number of organizational structures that include consumer/patient representation in recent years, including:

  • Patient and Family Advisory Councils;
  • Advisory Boards with Consumer Representation;
  • Quality Improvement Committees;
  • Community Benefit Taskforces;
  • Patient Advocate Offices;
  • Corporate Boards with Consumer Representation;
  • Boards or Committees Designing Alternative or New Care Models;
  • Shared care/ shared decision-making systems;
  • Portals of websites for gathering consumer insight; and,
  • Focus groups for gathering consumer input, and Patient experience surveys.

Despite these efforts, study participants reported many of the same barriers to including consumers in governance and system reform activities, including difficulty with identifying and onboarding consumers (particularly non-retired consumers), lack of staff and resources, and an underlying resistance to change.

“There is a realization that consumers need to be engaged not just as patients but as participants in the value model design and governance of our delivery systems,” said Micklos. “Providers clearly have an opportunity to better involve consumers.”

This study builds on prior work by the Task Force help systems move towards more person-centered care. The Addressing Consumer Priorities in Value-Based Care framework offered a set of six guiding principles and key questions to facilitate consideration of consumer priorities in the development of person-centered care policies and practices.

About Health Care Transformation Task Force

Health Care Transformation Task Force is a unique collaboration of patients, payers, providers and purchasers working to lead a sweeping transformation of the health care system. By transitioning to value-based models that support the Triple Aim of better health, better care and lower costs, the Task Force is committed to accelerating the transformation to value in health care. To learn more, visit

Task Force Members: Aetna • agilon health • Aledade •  American Academy of Family Physicians •  Archway Health  • Ascension • Atrius Health • Blue Cross Blue Shield of Massachusetts • Blue Cross Blue Shield of Michigan • carecentrix  • ChenMed • Cleveland Clinic  • Community Catalyst • Concerto Health • Dartmouth-Hitchcock Health • Dignity Health • Encompass Health • Evolent Health • Greenville Health System • New Mexico Health Connections • Heritage Provider Network • HRHCare • Mark McClellan • National Health Law Program • National Partnership for Women & Families • OSF HealthCare • Pacific Business Group on Health • Partners Healthcare • Patientping • Premier • Remedy Partners • SCL Health •  The Dartmouth Institute for Health Policy & Clinical Practice • Trinity Health • Tucson Medical Center • Washington State Health Care Authority  • UAW Retiree Medical Benefits Trust