Uncomfortable Truths: Why Healthcare Coordination in Austin is Broken

This engagement explored what it would take to coordinate the healthcare of complex patients who are treated by many different providers, with a goal of more patient-centered care and better outcomes. Our collaboration partner in this work was the Community Care Collaborative (CCC),  a community organization established to provide a framework for implementing the Texas 1115 Medicaid Waiver and an Integrated Delivery System for the provision of healthcare services to the uninsured and underinsured populations of Travis County. 


Wicked Problem

Coordination of care across providers doesn’t exist.


Radical Strategy

Illuminate the underlying root causes. Distill the complexity.




The patient and the health system are at odds in at least nine commonly occurring collisions.




We broke down the complexity of healthcare coordination and identifed nine specific design problems to solve that are applicable to most health systems.

This work was foundational to the service blueprint work at the heart of UT Health Austin service standards.




We learned just how difficult it is to get more than two separate entities of the system to coordinate on care delivery. The collisions are a major finding of how different parts of the system are not aligned.

We co-designed with a payer, the CCC, but the work would have benefited by having a provider partner at the table from the start. We never launched this blueprint with one of the CCC’s providers, so it felt like an unrealized set of ideas and solutions. The insights and blueprint provide an incredible north star for others to pick up on. In fact, our work with UT Health Austin benefitted from this body of work and applied many of the solutions.