By taking an innovative approach to classifying patient populations, health systems can more effectively prevent “triple fail” events — or outcomes that fail to advance population health, reduce healthcare costs and improve patient experiences and satisfaction, according to a recent Walgreen’s study published in Health Affairs.
Research in the article, “How Health Systems Could Avert ‘Triple Fail’ Events That Are Harmful, Are Costly, And Result in Poor Patient Satisfaction,” examines how classifying (or ‘stratifying’) patients according to individual risk and expected response to an intervention can further the “Triple Aim.” The Triple Aim framework, created by the Institute for Healthcare Improvement (IHI), asks that health systems evaluate performance by simultaneously pursuing three dimensions: improved patient experience of care (including quality and satisfaction), improving population health and reducing per capita cost of healthcare.
The article examines two approaches that have been used to achieve the Triple Aim: the population strategy, which seeks to lower risk across an entire population; and the targeted strategy, which seeks to lower risk by identifying and intervening with high-risk individuals.
The “stratified approach” is presented in the article as a third and novel method, focused on identifying and prioritizing subpopulations according to their risk of health encounter failures and their likelihood of benefiting from preventive care. To identify at-risk subpopulations, health providers must analyze medical claims, pharmacy claims, electronic health record information and other administrative data to predict individuals’ risk of different triple fail events.
Source: Walgreens April 11, 2013:
Guide to Accountable Care Organizations, lays the groundwork for an ACO program, delivering a comprehensive set of 2012 ACO benchmarks from 200 companies, a framework for clinical integration, a key ACO prerequisite that puts participating providers on the same performance and payment page; and guidelines for physician-led ACOs.