To improve care delivery and achieve the Triple Aim of better care, better health and lower costs, hospitals and healthcare providers must implement several key principles, according to a joint report from two American Hospital Association (AHA) committees.
The AHA's Committee on Performance Improvement identified seven principles for improved system design:
- Center the "whole person" in the system design
- Develop systems for care management and coordination
- Incorporate behavioral health and social health determinants into the equation
- Work toward collaborative leadership
- Align care delivery and the community
- Give the system and those who work within it the technology, information and transparency they need to improve outcomes
- Create high-safety, high-reliability healthcare organizations
Meanwhile, the AHA's 2015 Committee on Research studied existing payment models that developed as healthcare shifted from volume-based to value-based care models. It found such models have revolved around three different approaches to payment:
- Service-based payment, modeled after traditional fee-for-service systems
- Population-based payment, an aggregation of overall care and costs throughout the care continuum
- Bundled-based payments, in which multiple different providers and services are aggregated together
The AHA issued several long-term policy recommendations in conjunction with the release of the committee findings, including appropriate blending for assorted payment models; improved risk adjustments for payment models; incentives for patient health; clarification of high-risk patients' payment policies; and improved payment rates for bundled payments and global budgets.
As an example of successful application of such recommendations, the report cites the case of Roanoke, Virginia's Carilion Clinic, which assembled multidisciplinary teams to improve care coordination and adapt to evolving payment models.
Meanwhile, in the short-term, providers can take steps such as gathering all payer data, determining the cost of infrastructure development, providing incentives for increased bundling and securing funding for critical access and rural hospitals, according to the AHA.
To learn more:
- read the report (.pdf)