Improving Your Outcomes

Do you want to provide excellent results to your patients, and your clients? Do you want to achieve the triple aim of healthcare-focused care at a lower cost with better outcomes at the population level? If the answer is 'Yes', then you need to improve the quality of care you provide, and the service you provide. this is the goal of most providers.

As you may recall, the previous steps were:

1. Identification of critical processes with the highest priority.

2. Verification of customer (patient) requirements.

3. Documenting processes.

4. Development of process measurements.

I know some that don't. Such a waste of effort, Armed with the information gathered and developed in the first four steps, steps must be taken to address the findings. Energy must be spent on managing the most important processes so that the quality of care does not suffer. In my experience, most providers and service organizations do this. They are not interested in addressing changes that lead to better results.

Consider a group of primary care providers who have been caring for patients for many years. Most of their income comes from paid services. They have many patients who have Medicare. They work to meet government mandates such as Meaningful Use of EHR requirements. But, they focus on activities for services. They may excel at managing their on-premise billing processes, but their revenue will continue to decline.

 If they work on the triple aim—working to improve their outcomes—then they will be rewarded by private payers and CMS.

What are some examples of continuous improvement projects that lead to the triple aim? They stratified their patients into groups comprising the high-risk group. Methodist Hospital provides case management services to this group. In the last six months, they moved 50% of high-risk patients to the low-risk group, achieving the triple aim. You can read more about this success in an article from Health Leaders Media online.

Mercy Health Physician Partners of West Michigan is NCQA certified as a patient-centered medical home. They focus on patients with care plans tailored to the patient. A well-designed patient portal is part of access to care.

Accountable care organizations are another way to achieve the triple aim. Recently, CMS added another contracting model for ACOs – the Next Generation ACO Model. This model provides several ways to manage risk in the capital environment. We hope that more organizations will sign contracts with CMS to provide care in this model.