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One Foundation's Experience with Primary and Integrated Care Grantmaking: Lessons on Leverage and Policy Change

Abstract

Significant changes in health care practice usually require changes in compensation practice -- and may also require changes in licensing (of facilities and/or professions), certification and professional training. This is important work that requires a long-term commitment. And it may give rise to push-back from various sources invested in the current state of affairs:* Professionals, not wanting others to be licensed to perform similar services at lower reimbursement rates* Payers, not wanting to open a door to new categories of reimbursable services* Training institutions reluctant to alter curriculum, until it is clear that a new approach has staying powerFoundations are in a powerful position to speak out for change, as we "don't have a dog in the fight." That neutrality can be our strength, particularly as we become known for speaking clearly and from a basis in factual information and evidence-based approaches

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