An article co-authored by researchers at Walgreens and the National Health Service of Great Britain projects that by taking an innovative approach to classifying patient populations, health systems can more effectively prevent “triple fail” events – or outcomes which fail to advance population health, reduce per capita health care 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 health care system continue to mount, the triple aim framework has increasingly been recognized as critical to improving outcomes while lowering costs,” said Jeffrey Kang, M.D., Walgreens senior vice president, 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 classifying (or ‘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 (IHI), asks that health systems evaluate performance by simultaneously pursuing three dimensions:
- improved patient experience of care (including quality and satisfaction),
- improving population health and
- reducing per capita cost of health care.
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.