We got this.

This year-end piece is devoid of predictions and prognostication as frankly, it just feels like all bets are off right now. It’s time for extreme possibilists to act. That said, here’s a couple reasons for hope in 2019.

Healthcare

Recent court cases notwithstanding, 2018 saw citizen-led gains in Medicaid coverage in several of the 18 states that did not offer coverage made available by the Affordable Care Act. Even more encouraging, I was in Chicago in early December for the Camden Coalition’s annual Putting Care at the Center 2018 conference.

One of the highlights of the conference was the launch of the Blueprint for Complex Care, a strategic plan to support multidisciplinary care management innovations and accelerate opportunities to improve care for individuals with complex health and social needs. The blueprint was developed by the Camden Coalition’s National Center for Complex Health and Social Needs, the Center for Health Care Services and the Institute for Healthcare Improvement. You can read a recap of the conference and view the Blueprint here.

Increasingly, our long-running healthcare debate is a proxy for America’s view of itself and how we treat those in need. The midterm election results offered some clues, but this story about a hospital recommending a Go Fund Me fundraising campaign for a heart transplant procedure says it all. Reductio ad absurdum, anyone

Technology

A few weeks ago, I shared this article Paper Trails: Living and Dying With Fragmented Medical Records on social media. It tells the story of the human cost, disappointment, and unrealized potential of having patient medical information shared across health systems.

There are a lot of good people hard at work addressing these fundamental challenges facing the delivery of healthcare. I saw a version of story this play out in my own family while on boarding with a new client, PatientPing, who are working to address this exact problem.

For all the talk about blockchain, ML, and AI, we still have high rates of medical errors, claims rejections, and breakdowns in transitions of care. Sharing ADT feeds and demanding interoperability is not an end unto itself. We need to address basic workflows, leverage technology to communicate in real-time and increase the line of site across silos about a patient’s needs, and guide care teams and patients to better decisions and outcomes. In the end, this idea isn’t just about sharing data or connecting platforms; it’s about using technology to amplify our basic humanity.

So, if you are coming to San Francisco for the J.P. Morgan Healthcare Conference, consider attending a side meeting - The Future Of Medicaid Innovation Forum 2019 taking place on Tuesday, January 8 at Glide Memorial Church.

Philanthropy

Big philanthropy received its fair share of criticism this year amid seismic shake-ups and renewed debates about the definition of a nonprofit health system.

Donor advised funds have come under increased scrutiny as interest grows in accessing and regulating these unique philanthropic asset pools. Nick Salter wrote an April Inside Philanthropy article and followed it up with a piece in ImpactAlpha. He makes the case for using donor advised funds for de-risking impact investing. I agree and am also a big admirer of how The San Francisco Foundation is working with its donor advised funds to address inequality. How can a system that originates in extreme wealth remake itself?

Here’s to what’s possible in 2019. Enjoy!