Executive Office Update: The harmonic convergence of collective impact

Thursday, January 01, 2015 11:07 AM

Doubling down on the Triple Aim

by Alfred Gilchrist, CEO Colorado Medical Society

The Colorado Health Foundation has announced a decade-long commitment of their considerable resources to support a community-level collaboration to accelerate the growth and effectiveness of the many ongoing “Triple Aim” efforts across Colorado to improve the care experience, population health outcomes and lower per capita costs.

Linking and syncing all the moving parts in a system-wide approach requires a novel strategy given the fragmented nature of care delivery and its many unintended care and cost byproducts. The Foundation convened multiple stakeholders to define the work of collaboration, under the mantle of BC3, which emphasizes their goal: Better Care, Better Cost, Better Colorado. The BC3 plan adapts from a framework being successfully deployed in other settings where scale and complexity work against reform efforts. It is known as collective impact, which by definition means overcoming the splintered nature of the isolated efforts by non-profits and other organizations tackling triple aim goals.

Collective impact starts by convening the doers and thinkers under a common triple aim agenda to build shared goals and measurement systems, along with mutually reinforcing activities and supporting communication initiatives. A backbone support organization will work with key influencers (including CMS), and other brand names in care innovation, to guide all of the downstream actions and help to grow and spread the work of high-performing innovators.

The potential to produce a wide range of policy options and market innovations, to bend the cost curve and improve quality is immense. The building blocks are already in place. The collective impact approach starts with momentum and leadership already underway in Colorado from both the public and private health care sectors. These leaders have incubated and launched numerous social experiments in care integration, payment reform and patient safety that have reached or extended well beyond proof of concept. We have an all-payer claims database, a high-functioning health insurance exchange, operational health information exchanges and a regionalized approach to Medicaid care management, all of which are improving health outcomes and saving tax dollars. We have reelected a governor whose team has championed a thoughtful and comprehensive approach to population health that is in near perfect harmony with our long-sought goals, and the pioneering work of the 208 Blue Ribbon Commission. Its intellectual progeny now includes the recently established Commission on Affordable Health Care.

The collective impact of matching and stacking these blocks in a cohesive collaboration requires the kind of leadership and funding support that the Colorado Health Foundation has brought to the table. While other states are locked in partisan and interest group conflicts that produce zero-sum policy outcomes, Colorado just stepped up its positive-sum game dynamics by several orders of magnitude.