Participate in the Build

The Right People in the Same Room

The Minnesota Initiative will eventually require many kinds of participation. The immediate need is more focused.

We need to bring together a small group of people and organizations with enough shared interest, practical experience, institutional reach, and responsibility to determine whether this work is ready to advance.

Each participant will arrive from a different part of the system. One may understand the cost of providing healthcare to hundreds of employees. Another may understand cooperative development, public policy, rural communities, clinical operations, research, or the infrastructure required to support locally owned organizations.

No one participant is expected to hold the complete answer.

The purpose of the first table is to put the relevant parts of the answer in the same room.

Who Belongs at the First Table

The first meeting should include participants who recognize themselves in one or more of the following roles.

An Organization With a Population to Serve

An employer, credit union, cooperative, union, public entity, or other member-serving organization responsible for the well-being of a defined population.

An organization with hundreds of employees or members may already be spending millions of dollars each year on healthcare while still watching access, continuity, and outcomes deteriorate.

Its interest is practical: could a better organized primary care system improve the experience and health of its people while making those costs more understandable and manageable?

Cooperative Conveners and Developers

Organizations that understand how people with a shared need become a functioning cooperative institution.

They bring experience in coalition formation, member education, governance, cooperative law, development sequencing, and the relationships needed to bring otherwise separate organizations together.

Their interest is structural: can the cooperative model be applied to one of the most consequential shared needs facing Minnesota communities?

Experienced Cooperative Operators

Leaders from established cooperatives in agriculture, finance, telecommunications, purchasing, distribution, or other member-owned sectors.

They understand how local participation becomes shared capacity, how common infrastructure can support autonomous organizations, and what it takes to earn trust across a membership.

Their interest is both practical and historical: can the same cooperative problem-solving that built essential infrastructure in other sectors help rebuild primary care?

Public Leaders With Responsibility for Access

State, county, municipal, tribal, and regional leaders who see how healthcare access and cost affect families, employers, public budgets, workforce participation, and community stability.

They bring knowledge of public systems, regulatory conditions, local needs, available data, and the points at which policy either enables or obstructs a new model.

Their interest is public: can Minnesota create space for communities to build primary care capacity before further access is lost?

Community and System-Change Partners

Foundations, community development organizations, rural and urban institutions, and other groups able to convene, support early development, or connect the initiative to communities facing the greatest need.

They bring relationships, perspective, and the ability to support work that must occur before a complete operating institution can finance itself.

Their interest is catalytic: can a limited early investment help establish a durable, community-owned solution?

Clinical and Evaluation Leadership

Clinicians, primary care designers, researchers, and evaluators able to examine the clinical framework, pressure-test the representative arcs, and establish credible methods for judging progress.

They help ensure that the cooperative structure remains accountable to care and that claims about outcomes, utilization, and cost can withstand serious review.

Their interest is evidentiary: can the model define and demonstrate better primary care across the complete arc?

Why These Participants

The first table needs more than general support for improving healthcare.

It needs participants who can bring at least one of the following:

• a population whose primary care needs could be better served;
• healthcare costs significant enough to justify a different approach;
• experience building or operating cooperative institutions;
• the ability to convene organizations around a shared need;
• knowledge of public policy, regulation, or community infrastructure;
• clinical expertise capable of testing the model;
• evaluation expertise capable of testing the evidence;
• or resources that can support disciplined early development.

Together, these participants can evaluate the project from the perspectives that matter most: clinical soundness, member need, financial logic, cooperative feasibility, public value, and capacity to execute.

Why Meet Now

The first meeting is timely because the work has reached a useful threshold.

PrimaryCare.Solutions provides:

• a developed clinical framework;
• a clear account of how the model differs from episodic care;
• the hub and arc-of-care operating logic;
• an outcomes-first approach to validation;
• a defined role for therapeutic and community resources;
• a financing premise centered on directly funding primary care capacity rather than isolated billable events;
• a six-stage development roadmap;
• and a clear distinction between what is established and what must still be built.

The participants are therefore being invited to examine substantive work, not gather around an undefined aspiration.

At the same time, the legal structure, anchor agreement, final fee strategy, governance, operating design, and local resource network remain open enough for the coalition to shape them responsibly.

What the First Meeting Should Accomplish

The first meeting is an orientation and working conversation. Its purpose is to establish a common starting point.

Participants should leave able to answer:

1. What problem is PrimaryCare.Solutions designed to solve?
2. What has already been developed and tested?
3. How does the proposed model organize care differently?
4. What resources are already available in Minnesota?
5. What must be completed before a first build can begin?
6. Which assumptions require further examination?
7. Who else needs to be involved?
8. Is there enough shared interest to continue the work together?

The immediate objective is informed alignment. Commitments should follow understanding, evidence, and a clearer view of each participant's potential role.

What Participation Means Now

Participation in the first meeting means:

• reviewing the framework and roadmap;
• bringing relevant experience and institutional perspective;
• testing the reasoning and assumptions;
• identifying missing knowledge or participants;
• and helping determine whether the initiative should move into a more formal coalition process.

The first meeting is not a request to endorse a finished plan, commit an organization to membership, or fund a full operating model.

It is an invitation to decide whether the foundation is credible, the need is sufficient, and the opportunity is strong enough to warrant the next conversation.

The Invitation

If you are responsible for a population, a healthcare budget, a cooperative institution, a public system, a community resource, or knowledge essential to this build, there may be a place for you at the first table.

You do not need to arrive knowing the entire model. The purpose of gathering is to create that shared understanding.

What matters is that you recognize the need, see a possible connection to your work, and are willing to examine whether Minnesota can build a better primary care system from the resources already within reach.

Start with the Minnesota Roadmap if you want to see the full path before the first table meets.

If you believe you belong in this conversation and have not yet been contacted, reach out directly at .

The Circle Will Widen

If the first group determines that the work should advance, the circle of participation will expand.

The complete build will eventually require:

• patients and member representatives;
• primary care clinicians;
• physical and occupational therapists;
• mental health practitioners;
• acupuncturists and other appropriate therapeutic disciplines;
• nutrition and health education resources;
• pharmacy, laboratory, diagnostic, and specialty partners;
• telehealth and technology support;
• legal, actuarial, insurance, and financial expertise;
• cooperative governance and development specialists;
• research and evaluation partners;
• funders and capital partners;
• and additional communities interested in future local builds.

Those relationships should be added as the roadmap establishes the need for them. The immediate task is to form the first table capable of carrying the work into its next stage.

The Work Before Us

PrimaryCare.Solutions began with a clinical question:

What would primary care look like if better health and quality of life were its operating objectives?

The Minnesota Initiative asks the next question:

Can the people and institutions who hold the necessary pieces bring them together into a community-owned primary care system?

The first meeting is where we begin answering it together.