In the pursuit of advancing payment reform, the Network for Regional Healthcare Improvement (NRHI) is leading a multi-regional innovation initiative focused on the production, sharing and use of information about the total cost of care. With funding from the Robert Wood Johnson Foundation, five pioneering regional health improvement collaboratives (RHICs) are now joined by six additional regions in a unique approach to standardizing how they report cost information. Balancing local customization with alignment to national efforts makes the information consistent, relevant, and actionable.
New Learning Modules
The Getting to Affordability initiative has released two new Total Cost of Care (TCOC) learning modules entitled, “Building Stakeholder Engagement” and “Reporting Total Cost of Care.” We know that many of you are working on finalizing your Phase III RFPs and we hope these new modules will assist you in that process. To view the Learning Modules, you need to be a member of the Getting to Affordability (G2A) online community. To join the G2A community go to g2a.healthdoers.org/home and select “join” in the upper right hand corner. If you have any questions please contact our Community Navigator Lucy McDermott, . Happy learning!
Case Studies: New Resources in Overcoming Barriers to TCoC Reporting
One of the goals of Total Cost of Care Phase III is to spread TCoC reporting across more regions. Recognizing that not everyone is at the same place in terms of readiness, during the second phase of the project, we selected four regions as Development Sites. Each of these regions selected a specific barrier that was impeding their progress toward healthcare cost transparency. They were funded to develop and implement strategies to overcome their barriers and didn’t need to start from scratch but leveraged the experience and lessons learned from those regions who have already reported TCoC. These case studies were written by the Development Sites and are intended to assist other regions who might have similar barriers and give them encouragement that barriers are surmountable. Below are links to these valuable resources:
- Washington Health Alliance (Alliance): A Case Study in Operating a Voluntary All Payer Claims Database
- Wisconsin Health Information Organization (WHIO): A Case Study Measuring Total Cost of Care in a Capitated Environment
- University of Texas Health Science Center at Houston: (UTHealth): A CaSe Study in Physician Engagement in Transparency
- The Health Collaborative of Greater Cincinnati: A Case Study in Public Reporting
NRHI’s TCoC Project Expands Again!
NRHI is pleased to announce that the Robert Wood Johnson Foundation has approved funding for Phase III of the Total Cost of Care Project. This is a two-year effort to improve transparency of healthcare costs by standardizing how costs are measured and reported, and how that data is used across different regions of the country. Leveraging the work done in Phases I & II, NRHI is looking for additional regions to join the Getting to Affordability initiative and spread healthcare cost reporting. Phase III is designed to meet regions where they are currently and help each move along the path to measuring and reporting total cost of care.
A Request for Proposal has been issued and applications will be accepted through December 12, 2016 at noon ET. There are three different levels of participation and funding available which are further described in the Request for Proposal – Total Cost of Care – Phase III Regional Expansion. We hope you find the resources below helpful and that you will consider exploring this opportunity.
Join the Getting to Affordability (G2A) Community
To gain a more thorough understanding of the Total Cost of Care project, access our Learning Modules, obtain more resources and interact virtually with others embarking on this work, we strongly suggest you join the Getting to Affordability community. The registration process is open to everyone by clicking on the following link: https://g2a.healthdoers.org/home. If you have any issues or questions about the G2A Community, please contact Lucy McDermott, G2A Navigator at .
Attend the RFP Expansion Region Informational Webinar
NRHI will host an informational webinar on Thursday, November 17, 2016 from 3:30 – 4:30 PM ET. Click here to register. This webinar will be recorded and posted here on this webpage as soon as possible. Questions about the webinar or issues with registration may be directed to Mary-Isabel Aromando, Project Manager via e-mail at or at (207) 805-1683.
Submit RFP Questions
Questions about the RFP may be submitted by clicking here. All questions and answers will be posted here in the Frequently Asked Questions (FAQ) document. For assistance with accessing the web form or FAQ’s, please contact Mary-Isabel Aromando, Project Manager via e-mail at or at (207) 805-1683.
Review the Technical Resource
NRHI, in collaboration with the APCD Council produced the Technical Resource for Measurement of Total Cost of Care Using Multi-Payer Data Sets. Together we have worked to translate the standardized technical specifications and lessons learned from the TCOC pilot regions into a more formal how-to guide for measuring and reporting total cost of care. We encourage you to review this resource in advance of responding to the RFP and use as a reference to answer some of the specific questions. Click here to access the Technical Resource.
TCoC HealthDoers Release Technical Resource
The Total Cost of Care Project Team, in collaboration with the APCD Council, released the Technical Resource for Measurement of Total Cost of Care Using Multi-Payer Data Sets. Filled with Voices from the Field, readers will benefit from the insights, guidance and tips from the five original TCoC pilot regions. This documents three major phases of the work (data preparation, assignment of risk scores and the use of the HealthPartners software) and includes the detailed analytic steps leading to the calculation of TCoC using a multi-payer data set.
This effort was funded by the Robert Wood Johnson Foundation to promote spread of standardized TCoC measure across the country. To continue conversations, share best practices and get peer support around measurement of Total Cost of Care – join the Getting to Affordability Community by emailing .
National Employer Leadership Seminar Summary Report
Click here to read the full summary report from NRHI’s National Employer Leadership Seminar. The Report offers tools, case studies and best practices for employers working to accelerate healthcare transformation. The Report summarizes lessons learned during the National Employer Leadership Seminar (NELS) in Charlotte, North Carolina, on May 5 and 6, 2016. The landmark seminar was supported by the Robert Wood Johnson Foundation as part of NRHI’s Getting to Affordability initiative and focused on three objectives for moving the private sector from volume to value in healthcare:
- Create a shared understanding of the national landscape, present and future, and the role of stakeholders toward paying for value.
- Identify levers available for employers to influence and drive the availability of higher quality, affordable healthcare.
- Demonstrate how regional, multi-payer data can be utilized as a catalyst for change.
2nd National Physician Leadership Seminar Held in Stanford, CA August 4-5
On August 4-5, the Network for Regional Healthcare Improvement (NRHI) brought together physician leaders, healthcare measurement experts and colleagues from across the country to look at comparative health care cost reports and analyze their usefulness in identifying cost variations and interventions as well as how they can be used to influence and energize teams in clinical transformation.
“The National Academy of Sciences consistently releases reports that show 30-40% waste in healthcare services and spending. This is a national economic crisis. We can make progress and data is a critical tool,” said Arnie Milstein, MD, Clinical Excellence Research Center Director at Stanford University.
This was the second National Physician Leadership Seminar organized by NRHI and funded by the Robert Wood Johnson Foundation as part of the Total Cost of Care Initiative, which seeks to produce actionable, practice-level reporting structures to identify the drivers of regional healthcare costs and develop strategies to reduce spending at the community level.
Click here to read the full press release.Project Updates
- The Total Cost of Care Phase II Project takes on a new look as part of NRHI | Getting to Affordability
- If you’ve been following the Total Cost of Care project since its beginning in 2013, you know that the name of the project has evolved over time to reflect the HealthPartners measure which is at the center of the work.
- While the Total Cost of Care measure is still the foundation of cost measurement and reporting, the second phase of the project expands on stakeholder engagement and identifying methods to more rapidly scale a standardized and aligned approach to reporting on cost of care.
- To better reflect the breadth of the project, Total Cost of Care Phase II will now fall under NRHI | Getting to Affordability.
- To understand the vision for this work and for an example of how its impact, read our overview one-pager, on NRHI | Getting to Affordability.
- To learn more about the NRHI | Getting to Affordability approach and the 11 regions now participating, view the Total Cost of Care Phase II Accelerates Healthcare Affordability one-pager.
- For a quick orientation to the Total Cost Index, watch our video below:
- The Getting to Affordability Vision provides a high level, one page overview or those interested in understanding why this work is valuable and needed, including use cases.
- Getting to Affordability: Total Cost of Care Phase II Accelerates Healthcare Affordability is a one page overview of how each of the participating regions are working toward accelerating healthcare affordability, making a regional commitment for national impact.
- Evolving the Regional Total Cost of Care Project: An Overview of Phase II is an early look at the goals of phase II.
- Evaluation: Total Cost of Care Phase I Pilot Project was written by Health Management Associates and includes interviews with each of the pilot regions.
- The Total Cost Care Pilot Executive Summary captures the work of phase I.
- The HealthDoers Who Have Done It booklet provides a personal perspective on the pilot
Recordings and Events
- 2nd National Physician Leadership Seminar Held in Stanford, CA August 4-5On August 4-5, the Network for Regional Healthcare Improvement (NRHI) brought together physician leaders, healthcare measurement experts and colleagues from across the country to look at comparative health care cost reports and analyze their usefulness in identifying cost variations and interventions as well as how they can be used to influence and energize teams in clinical transformation. Click here for the press release.
- National Summit: Cost Transparency from the Ground Up April 30, 2015 On April 30, 2015 more than 125 stakeholders representing Regional Health Improvement Collaboratives (RHICs), physicians and healthcare systems, public and private payers and insurers gathered in Washington, DC to learn from the five (RHICs) that have worked together to implement and standardize Total Cost of Care reporting across their regions. To learn more about the event, view the materials and presentations, click here.
- National Physician Leadership Seminar August 14-15, 2014 This Leadership Seminar, held August 14-15, 2014 at Stanford University, provided a forum where physician leaders from around the country and measurement experts gained a better understanding of cost measurement to improve care. This Seminar offered a game-changing opportunity to enable physician leadership to lead change in the community.
About Total Cost of Care Pilot - Phase I (November 1, 2013-April 30, 2014)
NRHI and five of its member collaboratives worked together on a seminal study that makes significant inroads in addressing healthcare costs. The goals of the initiative were to:
- Measure and publicly report the total cost of care (TCOC) and resource use in a standardized way across five regions;
- Create a process for benchmarking multi-payer commercial healthcare costs;
- Identify the best ways to share cost information with key stakeholders in local communities to identify drivers and reduce healthcare costs;
- Conduct focused work with physicians to help them use cost information to adopt practices that will reduce costs and improve care, and to encourage them to serve as leaders in their communities
Participation in the Total Cost of Care Pilot (Phase I) includes the following Regional Health Improvement Collaboratives (RHICs):
- Center for Improving Value in Health Care (Colorado)
- Maine Health Management Coalition Foundation
- Midwest Health Initiative (St Louis, MO)
- Minnesota Community Measurement
- Oregon Health Care Quality Corporation
More resources and updates available about Phase I are available above.