"The two words ‘information’ and ‘communication’ are often used interchangeably, but they signify quite different things. Information is giving out; communication is getting through." -- Sydney J. Harris

MNCM Joins Second Phase of National Total Cost of Care Project

The Network for Regional Healthcare Improvement (NRHI) recently announced the second phase of its national Total Cost of Care project, which is funded by the Robert Wood Johnson Foundation. MN Community Measurement has been involved since the project’s inception, and was awarded a grant to continue our involvement in phase two.

“We are excited about what has been accomplished by this project to date and where the next phase will take our community and nation as we strive for increased cost transparency in health care,” said Jim Chase, MNCM President.

Minnesota’s health care community, led by MNCM, began working on TCOC in 2011 and released the nation’s first statewide total cost of care report in December 2014.

NRHI’s announcement marks the continuation of a project that began in late 2013 to leverage health care data to reduce health care cost and improve care. MNCM and regional health care improvement collaboratives from four other communities have spent the past 18 months developing the framework for standard collection and measurement of total cost of care (TCOC) across regions.

“This project enables us to look at the whole cost picture, rather than focusing on small, specific areas of utilization,” explained Tara Oakman, Senior Program Officer for the Robert Wood Johnson Foundation, in a Health Affairs Blog post. “As one person… put it: this project enables you to look at the whole balloon and how to reduce its size, rather than squeezing one part of it and having the shape change, but the size remains the same.”

The other organizations involved in the first phase of the project were Maine Health Management Coalition, Midwest Health Initiative (Missouri), Oregon Health Care Quality Corporation and Center for Improving Value in Health Care (Colorado).

Almost two years after NRHI first approached the Robert Wood Johnson Foundation about funding the project, the project has achieved its first major goal: to better understand the challenges and opportunities associated with measuring the total cost of care in a collaborative way at the local level, where health care utilization and spending is actually occurring.

The project leaders and five communities gathered for a national conference in late April to share the results of the initiative’s first phase, and the lessons learned thus far. They included:

  • Total cost reporting must be part of a multi-stakeholder effort that helps build trust in the community;
  • Cost reporting makes sense as the place for a community to start engaging in public reporting for a variety of reasons;
  • Reliable data is fundamental and crucial – you can’t build trust in your community without it; and,
  • The results must be useful; change doesn’t occur until the data can be used to identify unnecessary spending.

The second 18-month phase will continue data collection and testing of commercial claims data across regions, as well as evaluate expansion of the effort to include Medicare and Medicaid claims data. It will also continue to dig deeper on how TCOC data can be used by all stakeholders at the local level.

For more information, read NRHI’s announcement.