affordability

“A” Is for affordability Learn how HealthPartners’ Total Cost of Care framework is helping to ensure more affordability for all.

To be successful with most things in life, you have to see the big picture: the more information you have, the more empowered you are to reach your goals. The same can be said in healthcare. To make healthcare more affordable—while still maintaining care quality and experience—more actionable information is needed.

At HealthPartners, we created Total Cost of Care (TCOC) to help more people see the big (healthcare cost) picture.

As an employer, you can leverage TCOC by comparing how effectively providers manage costs for their patients. But before you do, let’s take a deeper dive into what TCOC is, how it works, and why it matters.

What is TCOC?

TCOC is a unique analytical framework HealthPartners developed to identify new ways to lower healthcare costs and increase affordability. It is a full-population, person-centered measurement tool that accounts for 100 percent of the care and treatment provided to a patient.

How does it work?

To calculate TCOC, we combine Resources Used (number and types of services used) with Prices Paid (fee schedule, referral patterns, appropriate place of service ((e.g. inpatient vs outpatient)). Together, these variables give us a broader, more comprehensive view of health care expenses. They also allow us to isolate practice opportunities from price opportunities—and make improvements in the right areas.

At HealthPartners, we’re proud to report that TCOC is endorsed by the National Quality Forum and is considered the national gold standard of population-based affordability. Having gone through two rigorous review processes, TCOC continues to be the only measure of its kind to be endorsed.

Why does it matter?

Using TCOC, providers can gauge their own cost-effectiveness in regards to the care they provide. They can see where they stand in relation to other providers who offer similar services and make more informed decisions that drive better health outcomes at lower costs. TCOC also identifies high prices, instances of overuse and inefficiency and highlights cost-saving opportunities.

The TCOC reporting suite supports multiple levels of analysis, so users can compare cost, resource, and utilization metrics by provider, by condition cohort or by procedure. The framework generates useful information to help employees make more informed decisions about where to seek care.

If you’d like to learn more about TCOC, check out a wealth of resources at: https://www.healthpartners.com/hp/about/tcoc/index.html

  • Vice President, Health Informatics and Health & Care Engagement. Sue has led the development of population-based total cost of care, providing tools and services to help medical groups improve performance, quality and experience. In her health and care engagement role, she is accountable for the strategic direction and operations to improve health and well-being in partnership with members, patients and the community.


    See more posts by Sue >

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