Avoiding the 5 Drivers of Low-Value Care

Friday, April 1st, 2011
This post was written by Jessica Fornarotto

HealthPartners’ multi-pronged approach to transforming healthcare includes the avoidance of the five drivers of low-value healthcare, explains Babette Apland, senior vice president of health and care management for HealthPartners.

HealthPartners is trying to achieve more Triple Aim results. We’re trying to do less of the primary drivers of low-value care, including the ‘more is better’ culture or a focus on volume rather than value of healthcare services. Second, we are avoiding supply-driven demand, which is rooted in Dartmouth’s work showing that the more supply or providers in a geography, the more volume or services that are delivered. Thirdly, we operate in many areas in healthcare without spending constraints, so having a view of total cost of care at the population level is important. Fourth, we have implemented and are increasingly enhancing a team-based approach to healthcare that is supporting doctors, but is not overly reliant on doctors. Finally, we also appreciate the need to create a system in healthcare that is consistent and reliable across the care continuum.

We see the keys to transforming healthcare through partnership and payment reform, reporting transparency and data analysis, clinical support, integrated population health management, and patient-centered care and innovation.

Looking at payment reform and our payment reform journey, HealthPartners began back in 1997 with our Partners in Excellence Program, creating bonus payments for providers achieving stretch quality of care goals. In 2001, we implemented a program that focused on improvement and added downside risk around quality improvement through a withhold. In 2009, we began implementing our total cost of care payment approach; today, in 2011, two-thirds of our claims as a health plan are from care systems with total cost of care agreements.

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