The Care Exchange

The Care Exchange is being formed to coordinate healthcare access in communities where access is fragile or absent: rural counties without obstetric care, urban underserved neighborhoods losing primary care infrastructure, communities watching their last pharmacy close. The Exchange operates as matching infrastructure: standby clinical capacity is matched to unmet demand through transparent rules and rule-based membership.

The Exchange does not deliver care directly. Members deliver care. The Exchange handles the rails: matching, credential portability across state lines where reciprocity exists, telepharmacy backbone, satellite delivery model coordination, and standby clinical workforce networks.

The Care Exchange is intended to be structured as a Public Benefit Corporation operating matching infrastructure. The PBC form is intended to lock the public benefit purpose in the certificate of incorporation, with the specific public benefit being healthcare access in underserved communities.

Operational design is intended to follow the structural lessons of state-based Health Insurance Exchanges that have performed well: independent governance, technical expertise, rule-based matching with published criteria, and accountability to multiple constituencies rather than to a single regulator or industry.

The patient constituency includes maternal health patients in counties where the obstetric ward has closed, pharmacy patients in counties where the last retail pharmacy has shut down, primary care patients in urban neighborhoods where the FQHC is overwhelmed or absent.

The provider constituency includes clinicians who have standby capacity to deliver care under appropriate arrangements: locum tenens networks, retired physicians available for telehealth, mid-career clinicians seeking part-time community work, and credentialed midwives expanding rural practice. The Exchange matches these providers to the patient demand the existing system has not met.

Governance is intended to include adversarial multi-stakeholder representation: state health departments, clinician organizations, patient advocacy groups, tribal health authorities, rural hospital associations, and FQHC networks. No single constituency is intended to hold more than one-third of board seats.

Matching rules are intended to be published and version-controlled through the platform Standard primitive. Outcome reporting is intended to follow patient-privacy-protective aggregation: maternity deserts reduced, pharmacy access preserved, primary care contacts coordinated. No individual patient data is published.