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Daniel Wolfson Discusses Mistrust, Quality Implications in the Health Care System


Daniel Wolfson, executive vice president and chief operating officer of the ABIM Foundation, speaks on factors influencing mistrust of the health care system and efforts to improve quality care.

A collaborative effort from all parts of the health care system, including employers, health plans, and pharmacy benefit managers (PBMs), is warranted to address growing feelings of mistrust among patients, said Daniel Wolfson, executive vice president and chief operating officer of the ABIM Foundation.

Wolfson recently participated in a panel discussion at the National Alliance 2021 Annual Forum titled, “Rebuilding Trust to Drive Health Care Value.”


Can you speak on some factors that contribute to mistrust in the health care system?

Recently, I was at a conference of employers from the National Alliance of Healthcare Purchaser Coalitions, and one of the questions that was asked was, "Why are the parts of the health care system—that is, the relationships between employers and health plans, and health plans and PBMs—why is it at an all-time low? It seems like there's more distrust going on."

My response to that was, we need to focus on common purpose, alignment of common values, and strong communication, deep listening, and understanding between the components of the health care system. Now, maybe we've all been inside, we haven't been communicating like we normally do and this is the result of it. Or I think, there's just a lot of fear and uncertainty in this environment that has maybe caused this mistrust.

I think, of course, in populations that have long had distrust of the system—earned distrust of the system—these things are boiling up and becoming very apparent to us in health care. And those components need to all work together to address the inequities in the health care system.

How has the national perspective regarding quality care changed in recent years?

I think what's going to change, and it's going to change rapidly, is a focus on equity. Measurement of health inequity, looking at safety incidents by race and ethnicity, looking at measures according to race and ethnicity. I think that is going to change the quality scene for the better.

I think there's a lot to learn from the equity arena that could help safety, and I think there's a lot of things in the safety arena that could help us with equity issues. So, I think that's going to be the biggest change. I think the trends that have long been around, of trying to decrease the number of measures, is going to continue to be a force and to really look at patient-reported outcomes in a much more focused way and in a way I think will address some equity issues if we begin to look at patient-reported outcomes.

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