By taking a different approach to classifying patient populations, health systems can do a better job of avoiding "triple fail" events, or outcomes that fail to advance population health, reduce health care costs and improve the patient experience, according to a research article from Walgreen Co.


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Walgreens research points to new approach for ACOs

April 10th, 2013

DEERFIELD, Ill. – By taking a different approach to classifying patient populations, health systems can do a better job of avoiding "triple fail" events, or outcomes that fail to advance population health, reduce health care costs and improve the patient experience, according to a research article from Walgreen Co.

Walgreens said Wednesday that the research, published in the April edition of the journal Health Affairs, examines how "stratifying" patients based on individual risk and expected response to an intervention can further the "triple aim."

Developed by the Institute for Healthcare Improvement (IHI), the triple aim framework calls on health systems to gauge performance by pursuing improved patient experience of care (including quality and satisfaction), improving population health and reducing the per-capita cost of health care.

"As pressures on the global health care system continue to mount, the triple aim framework has increasingly been recognized as critical to improving outcomes while lowering costs," Dr. Jeffrey Kang, senior vice president of health and wellness services and solutions at Walgreens, said in a statement. "At Walgreens, we have seen firsthand through our work with physicians, health systems and our own ACOs the importance of looking for innovative approaches to coordinating care — such as the one analyzed in this article — to keep populations healthy."

The article, titled "How Health Systems Could Avert 'Triple Fail' Events That Are Harmful, Are Costly And Result in Poor Patient Satisfaction," examines two approaches that have been used to achieve the triple aim: the population strategy, which aims to lower risk across an entire population, and the targeted strategy, which seeks to reduce risk by identifying and intervening with high-risk individuals.

Walgreens said the "stratified approach" is presented in the article as a third and novel method, focused on identifying and prioritizing subpopulations according to their risk of health encounter failures and their likelihood of benefiting from preventive care. To identify at-risk subpopulations, health providers must analyze medical claims, pharmacy claims, electronic health record information and other administrative data to predict individuals' risk of different triple fail events.

"Our findings suggest that if organizations expand their thinking around how to classify patients in order to take a more predictive approach aimed at preventing triple fail events before they occur, the potential benefits for all stakeholders would be significant," stated Ian Duncan, vice president of clinical outcomes and analytics at Walgreens. "Ultimately, this method could become a model for how to address population health and how to help meet the needs of patients, health systems, payers and providers."

Geraint Lewis, chief data officer of the NHS Commissioning Board and former senior director of Walgreens clinical outcomes and analytics, is slated to present the editorial findings at the Triple Aim Goes Global Health Affairs event on April 11 in Washington, D.C.

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