DEERFIELD, Ill. — A new Walgreens research article released Wednesday projects that by taking an innovative approach to classifying patient populations, health systems can more effectively prevent “triple-fail” events — or outcomes that fail to advance population health, reduce per capita healthcare costs and improve individual patient experience. The article, titled “How Health Systems Could Avert ‘Triple Fail’ Events That Are Harmful, Are Costly, And Result in Poor Patient Satisfaction,” was published in the April edition of Health Affairs.
“As pressures on the global healthcare system continue to mount, the triple-aim framework increasingly has been recognized as critical to improving outcomes while lowering costs,” stated Jeffrey Kang, Walgreens SVP health and wellness services and solutions. “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 research examines how stratifying patients according to individual risk and expected response to an intervention can further the “triple aim.” The triple-aim framework, created by the Institute for Healthcare Improvement, asks that health systems evaluate performance by simultaneously pursuing three dimensions — improved patient experience of care, improving population health and reducing per capita cost of health care.
“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,” commented Ian Duncan, VP clinical outcomes and analytics, 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.”
The article examines two approaches that have been used to achieve the triple aim — the population strategy, which seeks to lower risk across an entire population; and the targeted strategy, which seeks to lower risk by identifying and intervening with high-risk individuals.
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.
Geraint Lewis, chief data officer of the NHS Commissioning Board and former senior director of Walgreens clinical outcomes and analytics, will be presenting the editorial findings at the "Triple Aim Goes Global Health Affairs" event on April 11 at the Barbara Jordan Conference Center in Washington.