Decentralized investing: A social innovation for broader patient engagement

Abstract

Despite the substantial increase in private equity ownership, proliferation of for-profit business models, and consolidation across healthcare organizations over the past decade, healthcare delivery continues to be characterized by poor patient-centricity and financial structures that incentivize care fragmentation. We present a novel framework in which healthcare systems engage patients to participate in a decentralized, public form of healthcare investment and, consequently, advise on decisions relating to healthcare delivery, education, research, and policy. We posit that patient-led unions, informed by healthcare experts and regional governments to ensure feasibility and regulatory compliance, are uniquely poised to create value per service-dominant logic and transform healthcare delivery. Patient-led unions have the potential to offer lower costs, better outcomes, and improved patient experience compared to for-profit, private equity models. Amid growing calls for a civil rights style-movement in healthcare to address longstanding disparities and inefficiencies in the system, decentralized patient investment can empower patients to advance effective and equitable population health.