This week, I spent two days on Capitol Hill with our lobbying team at DLA Piper and Rainfall Health board member Steve Ganyard. We met with Senate offices, committee staff, and healthcare policy leaders to introduce Rainfall Health, discuss the continued evolution of Medicare payment models, and advocate for the expansion of mandatory value-based programs like TEAM and CJR-X.
Washington welcomed us with nearly 100-degree heat, and I quickly learned that our lobbyist’s advice to wear comfortable shoes was not an exaggeration. Going back and forth between the House and Senate office buildings was a good reminder of all of the important work that happens not only behind closed doors but in between meetings and in hallways.
The trip also brought me back to the beginning of my career at the New York City Department of Health & Mental Hygiene, where I worked at the Primary Care Information Project. That experience shaped my interest in the intersection of healthcare delivery, technology, and policy. We were working with primary care providers to use technology and leverage data to improve care, and many of the challenges we were trying to solve then still exist today: how do we give providers better information, how do we coordinate care across organizations, and how do we make it easier for clinicians to focus on their patients?
Our second day happened to coincide with a very busy day on the Hill, with several Senate confirmation hearings taking place and the Capitol buildings filled with activity. Even with everything happening around us, the conversations we had focused on a very practical question: how do we help hospitals succeed as healthcare continues to move away from fee-for-service?
That shift has been years in the making. Accountable Care Organizations (ACOs) showed that aligning incentives around quality and total cost of care could change how providers manage populations. Bundled payment models, including CJR and BPCI, showed that hospitals could improve outcomes and reduce unnecessary spending when they were accountable for the entire episode of care, not just the procedure itself. CMS TEAM and CJR-X build on those lessons by applying episode-based accountability to some of Medicare’s most common surgical procedures.
A major focus of our conversations was on rural hospitals and how to invest in their continued success. These hospitals are being asked to prepare for new payment models while operating with limited resources and, in many cases, very thin margins. Many want to adopt AI and new technology solutions, but they do not always have the teams or budget to know where to start. That is the problem we are trying to solve at Rainfall Health. As our board member Steve Ganyard said it best, “we want to be the easy button for these hospitals”.
Hospitals should not have to make a large technology investment and hope it works. We want to make adoption easier by providing the technology, clinical support, and operational expertise hospitals need while aligning ourselves financially with their success. By taking on risk alongside our hospital partners, we have the same goal: helping them improve outcomes and succeed under TEAM. Having an at-risk revenue model also ensures that we have invested “skin in the game” with our hospital partner.
The part of this work that motivates me most is the impact on patients. The patients included in TEAM are often older adults undergoing major surgeries. Their recovery is determined by much more than what happens in the operating room. It depends on whether they receive the right support after discharge, whether medications are managed correctly, whether follow-up happens on time, and whether care teams can identify problems before they become complications.
This is why coordination matters. A patient’s journey does not stop when they leave the hospital, but historically our healthcare system has not always been designed to support what happens next.
As I write this from my flight home, I am reflecting on a productive two days in Washington. We left with new relationships, commitments to introductions with state hospital associations, and a better understanding of what hospitals need as they navigate this transition.
The work ahead is significant, but the direction is clear. Healthcare is moving toward greater accountability, and hospitals need practical solutions that help them deliver better care without adding more complexity.
That is the work we are focused on at Rainfall Health.
Jessica Ohlssen is Senior Vice President of Revenue at Rainfall Health.
Further reading: What Is the CMS TEAM Model? · R.A.I.N. Compliant™ Platform · Navigating the CMS TEAM Mandate