Midwest Health Institute: Ask Me Anything with Mary Jo Condon: Total Cost of Care

AMA with Mary Jo Condon

Senior Director, Partnerships and Projects at the Midwest Health Initiative

January 26, 2016

Q: What does TCoC mean to you?

A: Measuring Total Cost of Care is a first step to better understanding the variation in health care costs. In our community, we’re using the results to help physicians better understand how the cost of care for patients attributed to their practices compares to patients attributed to their peers. Further, we’re using the data to give our community a sense of the variation in health care costs across different populations. For example, we found if our region could stop patients from going to the emergency room for colds and other upper respiratory infections we would have enough money to fund 20 St. Louis-based start-up companies.

Q: Can you share more about your role and organization? What efforts do you/your team pursue to advance TCoC in Healthcare?

A: The Midwest Health Initiative brings together those who use, provide and pay for health care around shared priorities to improve the health of our region and the quality and affordability of its health care. MHI stewards a large, community claims data asset that informs our work. As Senior Director of Partnerships and Projects, I support our partners in using MHI’s data set and collaborative partnerships to achieve high-value health care. I also lead MHI’s work with NRHI and sites across the country to measure and report total cost of care. Our team has learned so much from those at NRHI, the Robert Wood Johnson Foundation and the other sites. We’re really fortunate to have the chance to learn from each other and together.

Q: What advice can you offer for others who seek to incorporate a TCoC focus in their work?

A: Get started. This work is hard. It takes time – technically and politically – but it’s worth it. Our communities need physicians to have difficult conversations with their peers and their patients about what’s driving health care costs and what needs to change. This data begins those conversations and the partnerships within regional health improvement collaboratives keep them going.

Q: What are some of your favorite resources/tools around this subject?

A: In addition to the resources developed by Health Partners of Minnesota and NRHI, I would check out the Health Management Associates evaluation of the first round of Total Cost of Care work. It details each of the NRHI pilot site’s experiences – successes, challenges and everything in between. We each had very different starting points but all of us grew in our understanding and use of the measures and provided valuable data to our physicians.

Q: Is there a particular person (co-worker, speaker, mentor) that you look to for thought leadership on TCoC? Who is at the forefront of this work?

A: I’m really inspired by physicians who see “doing no financial harm” as part of the Hippocratic Oath. Nationally, Dr. Jay Want, Chief Medical Officer at CIVHC, is clearly one of those physicians and he’s leading the effort to help other physicians understand that thinking. Locally, the MHI Physician Leadership Council members and the four Missouri physicians who attended the Total Cost of Care National Seminar for Physicians inspire me every time we talk. They are working hard each day to help their patients achieve the best health at the lowest possible cost.

Q: How does TCoC impact the greater Healthcare improvement movement?

A: For too long, we’ve been too comfortable focusing on the “double aim” and our reluctance to confront the high cost of health care has hurt our ability to achieve the best possible health outcomes and experiences for patients. Measuring total cost of care completes the Triple Aim.