Cost Cube Gerry Marr Chief Operating Officer, NHS Tayside
NHS Tayside Cost Profile 2006/07
NHS TAYSIDE COSTS 2006/07 Hospital & Community £469.31m (73.9%) Prescribing £76.21m (12.0%) Other Family Health £31.12m (4...
Inpats & Day Cases £191,713 (30.2%) A&E £5,595 (0.9%) Prescribing £76,055 (12.0%) Psychiatric £27,293 (4.3%) Outpatients £...
Elective Inpatients £93,044 24.0% A&E £5,595 1.4% Prescribing £76,055 19.6% Psychiatric £27,293 7.0% Outpatients (New) £35...
COST CUBE Cost per Head by GP Practice 2006/07 (incl. GMS)
COST CUBE Cost per Head by CHP (incl. GMS)
COST CUBE Range of Variation from mean Cost per Head between GP Practices
COST CUBE Range of Variation from mean Cost per Head between GP Practices Elective Inpatients Non Elective Inpatients Day ...
 
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The ‘Triple Aim’ Gerry Marr Chief Operating Officer NHS Tayside
The “Triple Aim” Health of the  Population Experience of Care Per Capita Cost
Macro-Integrator <ul><li>It is not  a new structure or organization </li></ul><ul><li>It pulls together the resources to s...
Some System Components to Accomplish the Triple Aim <ul><li>Individuals and families </li></ul><ul><li>Redesign of “primar...
1. Individuals and Families <ul><li>Partnership between families and caregivers for learning and enabling.  </li></ul><ul>...
2. Redesign of “primary care” services and structures <ul><li>Team definition </li></ul><ul><li>Modes of access to service...
3. Population health management <ul><li>Useful segmentation of the population, for example by level of family support or b...
4. Cost control platform <ul><li>Defining and measuring per capita cost </li></ul><ul><li>Target for inflation </li></ul><...
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Cost Cube Triple Aim[1]

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Presentation by Gerry Marr NHS Tayside 14th November 2008

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Cost Cube Triple Aim[1]

  1. 1. Cost Cube Gerry Marr Chief Operating Officer, NHS Tayside
  2. 2. NHS Tayside Cost Profile 2006/07
  3. 3. NHS TAYSIDE COSTS 2006/07 Hospital & Community £469.31m (73.9%) Prescribing £76.21m (12.0%) Other Family Health £31.12m (4.9%) Other Non-Clinical £9.92m (1.6%) General Medical Services £43.73m (6.9%) Administration £4.93m (0.8%)
  4. 4. Inpats & Day Cases £191,713 (30.2%) A&E £5,595 (0.9%) Prescribing £76,055 (12.0%) Psychiatric £27,293 (4.3%) Outpatients £35,175 (5.5%) Labs £4,263 (0.7%) Radiology £3,464 (0.5%) Unassigned £248,012 (39.0%) NHS TAYSIDE ASSIGNED COSTS 2006/07 General Medical Services £43,633 (6.9%)
  5. 5. Elective Inpatients £93,044 24.0% A&E £5,595 1.4% Prescribing £76,055 19.6% Psychiatric £27,293 7.0% Outpatients (New) £35,175 9.1% Labs £4,263 1.1% Radiology £3,464 0.9% NHS TAYSIDE COSTS ASSIGNED TO GP PRACTICE 2006/07 Day Cases £17,099 4.4% Non-Elective Inpatients £81,570 21.1% General Medical Services £43,633 11.3%
  6. 6. COST CUBE Cost per Head by GP Practice 2006/07 (incl. GMS)
  7. 7. COST CUBE Cost per Head by CHP (incl. GMS)
  8. 8. COST CUBE Range of Variation from mean Cost per Head between GP Practices
  9. 9. COST CUBE Range of Variation from mean Cost per Head between GP Practices Elective Inpatients Non Elective Inpatients Day Cases Prescribing Outpatients (New) Psychiatry SMR04 A&E Laboratories Radiology GMS
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  13. 14. The ‘Triple Aim’ Gerry Marr Chief Operating Officer NHS Tayside
  14. 15. The “Triple Aim” Health of the Population Experience of Care Per Capita Cost
  15. 16. Macro-Integrator <ul><li>It is not a new structure or organization </li></ul><ul><li>It pulls together the resources to support a defined population </li></ul><ul><li>It optimizes the Triple Aim for the sake of a defined population </li></ul><ul><li>It works with and helps to improve micro-systems to support individuals </li></ul>
  16. 17. Some System Components to Accomplish the Triple Aim <ul><li>Individuals and families </li></ul><ul><li>Redesign of “primary care” services and structures </li></ul><ul><li>Population health management </li></ul><ul><li>Cost control platform </li></ul><ul><li>System integration </li></ul>
  17. 18. 1. Individuals and Families <ul><li>Partnership between families and caregivers for learning and enabling. </li></ul><ul><li>Memory of individuals anywhere they go </li></ul><ul><li>Joint planning and customizing care on best feasible outcomes </li></ul><ul><li>Patient-controlled personalized health record </li></ul>
  18. 19. 2. Redesign of “primary care” services and structures <ul><li>Team definition </li></ul><ul><li>Modes of access to services </li></ul><ul><li>Medication management </li></ul><ul><li>Cooperation and coordination with other specialties and hospitals </li></ul>
  19. 20. 3. Population health management <ul><li>Useful segmentation of the population, for example by level of family support or by type of disease </li></ul><ul><li>Use of predictive models to deploy resources to high risk individuals </li></ul><ul><li>Services customized by segment </li></ul><ul><li>Convenient access to information about health </li></ul><ul><li>Public health interventions </li></ul>
  20. 21. 4. Cost control platform <ul><li>Defining and measuring per capita cost </li></ul><ul><li>Target for inflation </li></ul><ul><li>Break incentives for supply driven care </li></ul><ul><li>New technology introduction </li></ul><ul><li>Focus on the individual as a cost reduction strategy </li></ul><ul><li>Yearly initiatives to reduce waste and the associated cost with all providers involved </li></ul>

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