Flip No. 43

A payment model that encourages bartering

How accepting services as payment might ease the financial burden of patients while also freeing up physicians.

By Flip the Clinic

Developed at Flip the Clinic Lab: San Francisco

Here are two unfortunate truths of our health care system: Physicians are overburdened, and good medical care is expensive for patients. As it stands, each party is stuck in their own silo; physicians can’t cut the cost of care for patients and patients can’t ease their physician’s load. But what if each party could agree to modify their existing roles just a little bit, so that both situations could improve?

One way forward is inspired by Burning Man, the 70,000-person event that takes place in the Nevada desert each August. Since 1986, groups of people have been coming together for a week to set up a city where there wasn’t one before. There are many unique things about this gathering, but one of the most astounding is that it runs on a so-called ‘gifting economy.’ Everything from food to art to body painting is offered by participants to participants, free of charge.

What if we took this general idea and applied it to health care? Could we encourage a multi-directional system of bartering that goes from patient to patient, from patient to clinic, or from clinic to clinic?

Imagine a patient trading something of value for medical care—maybe IT services, hours on a Patient Advisory Council, or group visit moderation. The clinic could tap its diverse population of patients to offer time, support, information or care. In return, patients could get something the clinic can offer, perhaps health coaching or additional preventive care planning. There’s an opportunity here to not only expand the existing payment models and ease the burden on clinicians, but also to foster an integrated community around the clinic, where working to improve the community also means improving one’s own health.