When did the Triple Aim become the Quintuple Aim - and why?
As a healthcare leader, you are probably familiar with the Triple Aim of Healthcare: enhancing patient experience, improving population health, and reducing the cost of care.
However, you may have missed the two recent aims added to this initiative. Today we will explain what they are and why they matter, particularly with respect to value-based care.
Speaking of value-based care, be sure to read to the end to seize a valuable feedback opportunity to the OIG regarding safe harbors to the Stark Law and Antikickback Statute.
You’ll also want to jump on the opportunity to register for our most popular webinar of the year on how the MPFS impacts your reimbursement, especially if you’re interested in Remote Therapeutic Monitoring, Chronic Pain Management, or Telehealth. (We’ve only got a limited number of seats, and it always fills up fast, so please register for this free webinar to be held on January 18 before we start promoting it widely.)
Now let’s get to the Quintuple Aim.
Care team well-being feeds into every other aim
As the fourth rail of the Quintuple Aim, care team well-being impacts every other measure. With almost 50% of providers reporting signs of burnout, the associated risks of lower patient satisfaction, reduced health outcomes, and even increased costs rise.
Some exciting innovations we’re seeing to address care team well-being:
Technologies to reduce physician burden, expand the reach of telehealth, and address labor shortages
Virtual-first and hybrid care options to reduce the strain on facility staffing, including direct-to-consumer lab testing and telepharmacy
Reimbursement for remote therapeutic monitoring and chronic pain management gives providers greater latitude over care options and spreads the care load among the team
Now, what’s the fifth aim?
Advancing health equity means understanding non-medical impacts to care
Social determinants of health drive 70% of health outcomes. Understanding these non-medical factors–income, social inclusion, food scarcity, and housing, to name a few–is key to advancing population health, eliminating social divisions, and even driving a more robust economy.
As a healthcare leader, this also extends to how you build solutions for greater inclusivity, improve access options for all types of patients, and even serve patients globally with different languages and customs.
Here are some additional insights to help you understand why health equity is a crucial component of Quintuple Aim:
Designing for inclusivity allows digital health companies to serve more people
Removing bias and exclusion in data helps companies serve patients better
Now that you understand why care team well-beng and health equity are key to improving healthcare in the US, we’d love to hear about what solutions you’re seeing in the marketplace that can move the needle.
Next we’ll explore a way you can advocate for better reimbursement now.
Value-Based Care Stakeholders: Tell the OIG what you think about safe harbors
You can see the conflict a mile ahead. The Federal Anti-Kickback Statute (AKS) and its safe harbor provisions within were created to prevent arrangements that incentivize the consumption of medically unnecessary healthcare. The AKS is based on a fee-for-service system where more healthcare would rack up more costs to the system without a corresponding improvement in health. However, for preventative services, the idea is that you want them to be provided more to prevent more expensive care down the road. And if you’re in a value-based care system, more care doesn’t necessarily mean more cost to the system.
Three reasons you may consider submitting feedback to the OIG (link below):
As currently drafted, the safe harbors are too limiting yet also too prescriptive to truly facilitate a transition to value-based care.
Changes would make the safe harbors more relevant for today's business models.
Updates could create more flexibility for care management and remote monitoring—services which have demonstrated improved outcomes and reduced costs
If you’d like to share your ideas for creating more opportunities for creative value-based care arrangements without violating federal fraud and abuse law, now is the time! Submit your feedback to HHS here, and if you need help drafting, please contact your NGL lead attorney.
And that brings this issue to a close…
Thank you for making room for us in your crowded inbox every month. You're busy, and we aim to deliver the most immediately useful information in each issue.
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We hope you have time at the end of this year to reflect on your achievements, spend time with family and friends, and prepare for a great year ahead. Our office will be closed from Monday, December 26, through Friday, December 30, so we can all take a much-needed break and come back strong in 2023.
Until next time, we wish you a fun and festive season with family and friends.
Carrie Nixon and Rebecca Gwilt and the entire NGL Team