July 18, 2019
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Teamwork can help Maine achieve health care’s Triple Aim

George Danby | BDN
George Danby | BDN

According to most national estimates, per-capita health care expenditures in Maine are among the top five in the United States. These high health care costs — nearly 20 percent of the state’s gross domestic product — have a crippling downstream impact on the economy and hurt the ability of businesses large and small to thrive, expand and move forward. High health care costs also squeeze needed investments in education, infrastructure and economic development and largely explain stagnant wage growth over decades.

While the reasons for this are fairly well known — we’re older, we consume a lot of health care services, we have a high rate of residents on some form of government assistance, some parts of the state lack medical infrastructure and we have increasing rates of chronic diseases like heart disease, diabetes and lung disease — solutions have been hard to come by.

Until now.

Recently, hundreds of experts from across Maine and the United States gathered in Portland for the annual symposium hosted by the Maine Health Management Coalition. The title of the event was “Finding Value: How to lower cost and improve health.” Attendees included local employers, health care providers, consumers and community leaders, and those assembled heard from national authorities on the issue of heath care costs and how to contain them. Closer to home — and more importantly — they learned about innovative approaches happening right here in the Pine Tree State. A common theme quickly emerged, and the news was refreshing indeed.

In the not too distant past, discussions in Maine about the cost of health care sometimes devolved into fingerpointing among various entities. But today’s climate is decidedly more collaborative. That is wonderful news for those who live and work in our state. Insurance carriers are teaming up with providers to better align reimbursement with the quality of health care services provided and improved outcomes as opposed to the quantity of services. Health care providers are developing more integrated and team-based systems of care built on a strong foundation of primary care and capable of managing patient populations to better health outcomes while restraining total costs. Employers also are making a contribution by using their worksites to promote healthier behaviors. Bath Iron Works, along with its insurance carrier, is providing special support to employees with diabetes, helping them lead healthier lifestyles, decreasing the need for costly medications and increasing workplace productivity.

These elements and others are why Maine is well on the way to achieving the so-called Triple Aim of health care. Developed by the Institute for Healthcare Improvement, the initiative outlines an approach to optimizing health care delivery through three parallel tracks:

— Improving the patient experience of care, including quality and satisfaction

— Improving the health of populations

— Reducing the per-capita cost of health care

Triple Aim provides a roadmap for communities to move forward, and it supports a collaborative and inclusive approach for getting there. No longer can employers, health care providers, insurance carriers, government agencies and others operate in silos, interacting only when absolutely necessary. IHI believes true positive change can only come about by marshaling all constituents and empowering the consumer to be an active participant in his or her own health and well-being.

It’s a belief we strongly endorse.

For more than two decades, the Maine Health Management Coalition has been proud to serve as a convener of ideas with and a primary mission of helping deliver more value for Maine’s precious health care dollars through five key initiatives: rewarding health care quality and efficiency, making cost and quality information easy for payers and patients to obtain, analyzing and sharing data for continuous improvement and monitoring, focusing health benefit plan redesigns on results and value, and engaging all Mainers to be part of the coalition’s efforts.

While there is still much to do, Maine’s health care future is indeed a bright one thanks to the many collaborative efforts underway. We look forward to continuing the conversation and welcome all to learn more about these innovations.

We can leave a legacy of a better and more reasonably priced health care system for all the residents of Maine.

Andrew Webber is the chief executive officer of the Maine Health Management Coalition. To learn more about the coalition and its work, visit mehmc.org.



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