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Triple Aim: balancing healthcare cost, outcomes and experiences

Improve the member experience, lower the cost of care, and improve health outcomes are the three objectives of ‘Triple Aim' healthcare.


How Collective Health balances experience, costs, and outcomes

By Rajaie Batniji, Co-founder and Chief Health Officer


Improve the member experience. Lower the cost of care. Improve health outcomes.

These are Collective Health’s core priorities in serving our employer clients and a critical part of our mission to make it effortless to understand, navigate, and pay for healthcare. They’re also well-known, and widely shared, priorities across our entire healthcare system. These three objectives are commonly referred to as the ‘Triple Aim,’ which was defined by the Institute for Healthcare Improvement (IHI) in a classic Health Affairs article as “improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations.”

The components of the aim aren’t strikingly novel, but the most important thing to understand about the Triple Aim is that these are NOT three separate goals. It is one goal with three aims that must be balanced. Very few interventions or companies organically pursue all three aims. It’s natural, for example, for a new treatment to improve outcomes and experience, but increase costs. That treatment falls short of the Triple Aim. As the IHI team wrote, “The balanced pursuit of the Triple Aim is not congruent with the current business models of any but a tiny number of U.S. health care organizations. For most, only one, or possibly two, of the dimensions is strategic, but not all three.”

Recent data from the Health Care Cost Institute (HCCI) shows that employer-sponsored healthcare spending recently hit a record high, all while patients continue to get less for more. As a partner to U.S. employers—the largest sponsor of healthcare in America—Collective Health takes the approach at every juncture to hit all three aims in this singular goal to be the platform for achieving high-value healthcare. This balance can be difficult, but in those times, we are aided by the fact that in working with self-insured employers, we’re serving the party in our healthcare system that may be most aligned with the pursuit of this balance.

Our Approach

Improving the member experience
We stay laser focused on our Net Promoter Score (NPS). It’s a customer satisfaction scoring index popularized by top consumer brands, and it’s our most valuable metric in determining how much of an impact we’re actually having on improving our members’ experience and their perception of the healthcare system—and in turn, how satisfied employees are with their employer’s health program.

Driving this NPS is our award-winning customer service, known as our Member Advocate (MA) program, which we’ve built from the ground up. Our NPS score is currently in the 70s, in line with companies like Apple and Amazon. Additionally, we provide intuitive digital tools with modern interfaces—the kind members interact with in their daily lives—that drive engagement among members who are increasingly using Collective Health as their main touchpoint to the healthcare system. Currently, 85% of households are utilizing a digital account via our mobile app or web.

Lowering the costs of care
Our software-driven approach—one that breaks down data silos to power intuitive products and unparalleled member support—helps lowers costs by enabling people to find the right kind of care, not avoid it. Our MA team is supported by proprietary technology that equips them with deep knowledge of each member’s health needs in order to guide them through their journey, and redirect their care when necessary.

Against an industry average of 6% annual increases in medical trend, Collective Health was able to drive a negative 0.3% medical trend in 2017 among clients who had been with us for 2 years or more. This number drops even lower among members who engaged with our MAs.

Improving health outcomes
The most challenging of the three aims to measure is health outcomes, in part because of the timelines of measuring healthcare outcomes in mostly working-age populations. This requires substantial data, collected over extended periods of time and thoroughly analyzed, in order to make well-informed assessments about the way a product is affecting the health of a population.

We’re working diligently towards this at Collective Health as we continue to assess key data from how members react to changes in plan design that promote high value care at a Center of Excellence to how members use services like online second-opinions to an onsite clinic. While there is extensive research on which drugs to combine for the best outcomes in managing high blood pressure, there has been little study into how our employer health plans shape our health outcomes.

We are allowing employers to instrument their plans so they can understand the levers that need to be pulled to improve outcomes. Consider the many innovative point solutions that have been brought to market targeting areas like maternity and fertilitybehavioral health, and a variety of chronic conditions. Collective Health is in a unique position to aggregate this data and enable employers to finally measure the impact of these programs on the health of their populations.

If you’re interested in learning more about Collective Health, we’d love to hear from you. Please fill out the form below.

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