Managing Total Cost of Care: A Powerful Lever
The Center for Medicare and Medicaid Innovation (CMMI) defines total cost of care (TCC) as the comprehensive basket of health care services utilized by a patient or population. In March 2016, the Integrated Healthcare Association (IHA) released California Medical Group Report Cards that included annual payments for care, or TCC.
What We Learned from Top Performers
In 2015, CQC interviewed top performing provider organizations from around the country to identify successful strategies to manage TCC. Representing a range of risk-sharing models, most interviewees focused on facility costs, including preventing admissions, avoiding readmissions, and improving patient management in skilled nursing facilities (SNFs). Read the results published by the California Heath Care Foundation.
An Opportunity for Provider-Led Organizations
CQC is offering a 15-month collaborative to support provider organizations in bending the cost curve. To guide the collaborative, CQC developed a “Playbook” that provides interventions to reduce avoidable facility costs like length of stay and hospital readmissions. The Playbook also addresses outpatient costs such as specialty injectables, imaging utilization, and other cost centers. Provider-led organizations are invited to apply!
To learn more about collaborative components, application process and participation requirements, download the letter of intent.
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