Advancing the Triple Aim Through Cost and Quality Transparency

Wednesday, March 9, 2016
Jeff Rideout, MD

In recent years, there has been a real effort to define and assess the value of health care services in terms of better care for individual patients, improved overall population health and smarter spending—the so-called triple aim.  Measuring, publicly reporting, and rewarding provider performance  based on value—or measures of clinical quality, patient experience, and costs—is key to making high-quality, affordable, patient-centered care more than a slogan.

Today, California physicians and health plans did their part to advance the triple aim by publicly reporting the total cost of care for the first time, alongside clinical quality and patient experience, at the physician organization level. Agreeing on a common way of measuring total cost of care and gaining buy-in to report the results publicly was no easy task—it took a lot of work and collaboration by California physicians and health plans to make it happen.

But the payoff is huge. Providing side-by-side quality and cost information for physician organizations—where care is delivered—can help consumers make more informed choices and encourage competition on cost and quality through provider performance improvement.

To our knowledge, this is the largest statewide multi-payer public report card to provide side-by-side assessments of physician organization performance on all three key aspects of value—clinical quality, patient experience, and costs. 

And the data show there is significant variation in the total cost of care across California—about $1,600 per patient per year—ranging from less than $3,158 on average per patient for 4-star medical groups in the least costly 10 percent to more than $4,744 for 1-star medical groups in the costliest 10 percent. The magnitude of variation indicates significant savings are possible if higher-quality, higher-cost medical groups can achieve performance levels comparable to higher-quality, lower-cost medical groups.

In a Health Affairs blog post,  IHA’s Jill Yegian, PhD, Dolores Yanagihara, MPH, and  Lindsay Erickson, MSPH, explore the significance of this breakthrough in public reporting of cost and quality information.

IHA Media Advisory: California Medical Group Report Card Now Includes Cost as Well as Quality Information

IHA Fact Sheet: Total Cost of Care

IHA Fact Sheet: Value Based P4P in California


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