posted by Sue Knudson, HealthPartners
on January 23, 2018
Every day we hear stories of members and patients struggling with high health care costs—from paying for basic necessities to enduring the unexpected. We know there’s much to be done to help improve affordability in our community and across the nation. And we remain strongly committed to making care and coverage affordable for all.
It’s said that you can’t improve what you don’t measure, and that’s true with affordability, too. While standardized quality measures have been common for years, health care cost measures have been far less so.
That’s what prompted my organization HealthPartners, an integrated, non-profit health care organization, to design a set of measures to identify health care cost drivers and opportunities. In 2012, they became the first measures of their kind to be endorsed by the National Quality Forum (NQF), the leading national standards-setting body. And last year, NQF re-endorsed the measures after another rigorous evaluation of their usability and value—a trust testament.
Our Total Cost of Care and Resource Use measures help organizations of all kinds identify cost drivers, drive affordability, and improve delivery of health care. They are unique in that they simultaneously measure cost of care and resources used to provide that care.
For example, the measures allow employers and consumers to compare health care providers based on cost over time, and when used in conjunction with quality, measure value. Providers can use the measures to better understand and manage cost drivers within their systems. Health plans can use them to drive development of new payment approaches. They can also inform benefit designs while improving transparency of provider performance reporting.
HealthPartners has been developing and using the measures for more than 15 years. Using this system, we have outperformed Minnesota, regional, and national risk-adjusted cost of care benchmarks for several years.
Today, more than 200 organizations in more than 35 states use the measures we developed to make health care more affordable, including national associations and many hospitals and health systems and insurance providers.
Following are just a couple of examples of the work being done. While each organization’s approach to affordability is unique, their efforts rest upon groundwork laid by the measures.
Using these endorsed measures, MN Community Measurement (MNCM) became the first community collaborative in the nation to release Total Cost of Care results in 2014. Since then, the data has been produced and displayed four years in a row. With this data, MNCM is able to compare cost data with quality and patient experience to improve health and maximize value for our community.
Its work has been shared nationally, leading others to adopt and implement the measures in communities across the country. View MNCM’s latest cost of care reports.
Under the leadership of the Network for Regional Healthcare Improvement (NRHI) and with support from the Robert Wood Johnson Foundation, 18 regions from across the country use the Total Costs of Care measures to develop a standardized method of reporting. This has enabled consistency and alignment across the nationwide network.
Seven regions have issued physician practice-level reporting and five contribute data for a national benchmark. Their efforts have focused heavily on expanding results, transparency, and stakeholder education surrounding health care costs. Through educational modules and local forums focused on affordability, NRHI and its members work to engage and educate stakeholders on the importance of total cost of care reporting.
We all have a role to play in helping make care and coverage more affordable for patients and health plan members. To this aim, HealthPartners has released the full measurement methodology.
This in-depth information is available without charge. It includes detailed scientific background, technical guidelines, reference guides, software, sample applications and guidance for adoption and use by other organizations.
Sue Knudson is Senior Vice President, Health Informatics, at HealthPartners.