Our Thinking


Tiny Tasty Morsels

By Maria Kordit, VP, Community Engagement, The Garage

The Garage's decade of experience in working with evolving and high-performing value-based organizations has empowered us to define an approach on how to change healthcare for good. This approach is the evolution from the Triple Aim to the Quintuple Aim and is something we execute every single day at the Garage.

The Quintuple Aim focuses on the following:

Lower Costs of Care | Better Care for the Patient | Improved Heath of Communities | Sustainable Service Model for Care Teams | Equitable Access to Care for All

There is a lot of effort, spend, and systemic utilization around clinical care when the overall health outcomes of communities and its population is driven by factors that are not being focused on today. Because of this, the system is not only slow to transformation but devotes 80% of all industry efforts to only influence 20% of health outcomes.

To build on this premise of defining our communities' health, we must understand the background.

  • Structural Inequities have led to Health inequities. This leads to 10% of total healthcare spending (~$340B) to be tied to these inequalities and expected to become a trillion-dollar problem in a decade.
  • 1/3rd of healthcare costs in the U.S. are waste, commonly from duplicate and unnecessary care.
  • Interoperability is on the rise now more than ever before. We see this commitment to data sharing daily as a technology company that participates in all parts of the ecosystem.
  • This empowers us to understand population density and identify cohorts of those with ongoing needs, episodic events, and those who are not on your organization's radar.
  • Consumer empowerment is also on the rise more than ever due to the pandemic pushing our industry into tech adoption with telemedicine.
  • Aging in place is a major focus and continues to be critical to the baby boomer generation, who are expected to take up 18% of the U.S. population by 2027.
  • Creating the Digital Front Door is critical as consumers have become more empowered than ever before to interact with their care team.

Principles to achieve Quintuple Aim

  • There can be no health equity and progress in community care without achieving data equity. This is paramount to building the necessary foundation that can empower individuals on the front lines to make a difference.
  • Understanding that cultural relevancy is essential for organizations to have true impact, as individuals in specific communities want to see somebody who can relate to them.
  • Providers should operate as social health networks, given we can overcome the challenges of current provider networks that do not have access, resources, or knowledge to function as a social network.
  • True Care quality cannot exist without health equity. This principle is grounded in our market lately as we define new programs and systems.
  • There is no ideal state, and we are on a journey. This has been a decades long journey that will continue making dents in as an evolutionary process.
  • It takes a village to drive outcomes. All constituents of the ecosystem in this blue ocean market have to effectively collaborate to change healthcare.
  • When we want to see equitable access for all, we have to build trust into the ecosystem within communities, coworkers, and the system-at-large.

Model to achieve Quintuple Aim

Model achieve Quintuple Aim

  1. The first component is simple - to build a community care model with the patient at the heart of it. In this model we see care teams, care partners, care administrators, and care researchers interlay with all constituents so the patient can benefit in this trusted ecosystem that is driven by data.
  2. Execute population heath management with four core functional pillars. The first pillar starts with advanced analytics of our populations and communities. Next, risk management to navigate performance outcomes combined with care management to achieve positive clinical outcomes. Patient engagement is a must focus in order to drive true impact and nowadays is often missed in strategy discussion.
  3. Build proper foundations and focus to drive high performance organizations. Currently organization devote most effort into analytics, care gaps, care management, and utilization. But we have seen our customers and partners successfully transform to become high performing organizations when they layer in focus on Risk Management, strategic partnerships with Labs and Diagnostics, Network Management to understand their Preferred Provider network, Patient Engagement, Remote Patient Monitoring, and addressing All Determinants of Health.

Architecture to achieve Quintuple Aim

Architecture achieve Quintuple Aim

  • Aggregating as much data as possible into a normalized view using our data engines and algorithms.
  • Serve that data as Tiny, Tasty Morsels in an INCLUSIVE hub to care teams empowering them to act on clear signals, not just noise. This allows us to bring our model pillars together with function and deliver these morsels to serve care managers, providers, and patients.
  • Whether it is the point of care intelligence, mobile apps, aggregated scorecards, or whatever may be that morsel relative to your organization's goals - we create that using our toolsets.
  • Create a unified view of these morsels, whether synchronous, asynchronous, or in-person engagement.
  • Enable universal sharing for collaboration within the ecosystem. These factors come together as Garage's cohesive strategy, not siloed, to achieve a true digital front door with access and universal sharing for the global ecosystem.

Best Practices to achieve Quintuple Aim
Looking at the best practices in achieving Quintuple Aim - there are none. No one has figured out how to achieve quintuple AIM at scale yet, but we believe there are a few things we can try that is worth the effort.

  • Know your population density, markets, and the community you are serving to identify your hotspots.
  • We must be all in on the digital-first-data-first approach. This is an essential first step and little progress can take place without it.
  • There is great value in forging partnerships. Community partnerships across the board are needed to help push resources towards these hot spots.
  • Engage the empowered consumer is in order to allow healthcare to truly change for good. We must focus on more strategies around this necessary practice.
  • Data has to be centralized, as we are already seeing CMS take strategic design around this. At the same time we must de-centralize the access to give individuals and patients the ability to make that difference.
  • Monitoring and measuring are a repeatable process in the application of these practices as we continue to learn and measure the outcomes necessary to bring true impact.

This is our journey together as we will continuously forge this framework to address evolving healthcare issues with all our partners and customers. With our Data-First-Digital-First strategy to achieve the Quintuple Aim, we can continue to gain insight into what our communities may need and support your organization in changing healthcare for good ... one community at a time.

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