Our Work Ahead: Focus on Delivering Cost Effective Care

Health providers are facing an uncertain market as plans for the ACA unfold quickly (repeal, replace, repair?). And yet, we have learned a lot these past few years of Obamacare. The IHI's Triple Aim was a foundational concept in the ACA, intended to improve quality, improve population health and reduce costs. New reimbursement models emerged that emphasized prevention and coordination of care. Early results demonstrate more cost effective care. If we are aligned in our interest to bend the cost curve in healthcare, we know what our work ahead is: focus on delivering cost effective care.

With so much uncertainty, the path forward is increasingly clear. Cost effective care is achieved through:

  • Better access to preventive care
  • Effective self-management of chronic diseases
  • Coordination of care across primary and specialty care 
  • Integration of care
  • Patient-centered care plans that enable patients achieve their goals

Our Work

The market is changing already, as it must. By March 2017, health insurance plans will have to start formulating what they believe they can offer for enrollment starting in October 2017. This is our window of opportunity on the provider side to design our systems to achieve cost effective care. To do this, we must continue our work in the following areas:

  • Know our cost drivers
  • Improve access to preventive care
  • Develop programs that enable patients to confidently manage their chronic diseases
  • Design our delivery model to achieve coordination of care across walls and systems so patients have a plan that they understand and can achieve
  • Make it easy for patients to pick us - access, virtual tools, wayfinding, coordination, patient-centered system design, responsiveness
  • Understand our path to financial sustainability 
  • Invest in the infrastructure to achieve high value, easy access care
  • Be prepared to negotiate with payers based on outcomes and cost effective care

This is our work this year and beyond. There is a great alignment of interests if we can bend the cost curve while delivering care that is effective and enables a healthier population.