Minnesota State Innovation Model GrantRequest for Information on

Health Information and Data Analytics in Accountable Care Models

This RFI is a joint project of the Minnesota Department of Health (MDH) and the Minnesota Department of Human Services (DHS). It is designed to obtain input from a variety of stakeholders on a subset of Minnesota’s State Innovation Model (SIM) Grant activities related to the health information technology, health information exchange, and data analytics needed to advance the Minnesota Accountable Health Model.

Questions are grouped by section. Responders are not expected or required to respond to every question and may comment on only those areas which are of interest or importance to them.

Released: 09/23/2013

Responses due: 10/15/2013

For questions, please email SIM@state.mn.us.

RFI Table of Contents

I. Introduction and Overview a. Summary Objectiveb. Who Should Respond?c. Use of the Term “Accountable Care”

II. Background a. Minnesota Accountable Health Modelb. SIM Grant Goals for HIT Infrastructure & Data Analyticsc. Supplementary Information

III. Procedures for Responding IV. RFI Questions

a. Section A – Increasing Participation in Accountable Models b. Section B – E-Health Community Collaboration Grants and Technical Assistance

Needsc. Section C – Data Analytics d. Section D – Other e. Section E - Respondent Information

V. Glossary of Terms – Working Definitions

Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

Introduction and Overview

The Minnesota Department of Human Services (DHS) and Department of Health (MDH) seek input on a subset of Minnesota’s State Innovation Model (SIM) Grant activities related to the health information technology, health information exchange, and data analytics needed to advance the Minnesota Accountable Health Model.

The responses will be used for planning, policy development and to develop requirements for future grants and competitive contracting for professional/technical services. This Request for Information (RFI) and responses to it, do not in any way obligate the State, nor will it provide any advantage to respondents in potential future Requests for Proposals (RFPs) for competitive procurement.

This RFI is one of many possible RFIs and RFPs addressing a range of components under Minnesota’s SIM grant. The objective of this RFI is to receive feedback specific to health information technology and data analytic barriers that may be experienced by providers desiring to participate in accountable care or total cost of care models, as well as those who are already or are considering becoming or partnering with accountable care organizations.

This RFI is only one mechanism that the agencies will be using to gather input on priorities and strategies for the SIM grant. Through formal and informal advisory bodies, community meetings, and other communications venues, DHS and MDH will be regularly seeking input and guidance from a broad range of stakeholders throughout the period of the grant.

Who Should Respond?

While this RFI is open to any individual or organization that chooses to respond, the target audience for the RFI includes:

Providers of health care services from a range of specialties and sizes, especially long term care providers and behavioral health providers

Non-clinical community organizations, neighborhood based agencies, social service organizations or local public health agencies that are or will be partnering with clinical health care providers to coordinate care for patients or populations

Provider systems that already participate in or are considering participating in accountable care payment arrangements

Payors of health care

Responders are not expected or required to respond to every question and may comment on only those areas which are of interest or importance to them.

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There are many parts of this RFI that use the terms “accountable care” or “Accountable Care Organization,” or “ACO.” These terms are being used to reflect the concept of a group of diverse health care providers that have collective responsibility for patient care and that coordinate services. This term is meant to include the broad range of health and health care providers that are not formally part of an existing ACO as defined by the Centers for Medicare and Medicaid Services (CMS) or other payers, but that are also moving towards greater accountability for the quality and cost of care they provide to their patients.

Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

Section A contains general questions about increasing participation in accountable care payment models. Perspectives from providers and payors, especially smaller and rural providers who are in various stages of planning related to these models are particularly sought in this section. Section B includes questions focused on e-health community collaboration grants and technical assistance needs. Responses from provider settings not included in previous HITECH funding including long term care providers, local public health, behavioral health providers, and social service organizations are especially desired in this section.

Section C focuses on data analytics. Responses from health plans, payers and provider systems already in accountable care models are especially desired in Section C.

Section D is for providing any additional comments that you think would be helpful for the State in making the determination for funding priorities and achieving the goals of the SIM grant.Please note: Input is welcome from any responder on any question.

Use of the Term “Accountable Care”

Background

Minnesota Accountable Health Model

The purpose of the Minnesota Accountable Health Model is to provide Minnesotans with better outcomes, experience and value in the health care system through integrated, accountable care supported by innovative payment and care delivery models that are responsive to local needs. The model will create an environment in which the following vision for delivery system transformation can be achieved:

Vision – By 2017, Minnesota’s health care system will be one where:

The majority of patients receive care that is patient-centered and coordinated across settings;

The majority of providers are participating in Accountable Care Organizations (ACO) or similar models that hold them accountable for costs and quality of care;

Financial incentives for providers are aligned across payers, and promote the Triple Aim goals and;

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Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

Communities, providers and payers have begun to implement new collaborative approaches to setting and achieving clinical and population health improvement goals.

SIM Grant Goals

The SIM grant will test whether Minnesota can improve health and lower costs by increasing the percentage of Medicaid enrollees and other populations included in accountable care payment arrangements, and whether investments in health information technology and data analytics can accelerate adoption of accountable care models. Under the Model, the state will expand the range of services for which Medicaid ACOs are accountable to include mental health, addiction services, and long term supports and services, including patients with more complex health needs, and will also promote and support expansion of accountable care models across payers. The focus is on the development of integrated community service delivery models and coordinated care models that bring together health care, behavioral health, long term supports and services, and community prevention services that are coordinated and centered around patient needs.

To achieve the vision of the Minnesota Model, the SIM grant includes significant investment in these areas, with the following specific health information technology and data analytic goals:

Secure exchange of information between providers occurs in a more seamless/real time way across settings (clinics, hospitals, long-term care, public health, behavioral health, and social services), for the purpose of more efficiently identifying opportunities for improvement and coordination, with the ultimate goal of improving health care.

Providers participating in the Medicaid Health Care Demonstration (HCDS) or other Accountable Care Organization (ACO) or similar models have access to clinical and claims data that support quality improvement, population management, and transitions of care, along with other identified priority transactions necessary to promote coordinated, high quality care across settings.

The state has a roadmap for the secure exchange of clinical health information across providers/settings, with specific roadmaps for behavioral health, long-term care, local public health, and social service providers and a focus on key transactions needed to support evolving ACO-type or coordinated care models.

Supplementary Information

For an overview of the SIM Grant visit http://mn.gov/health-reform/SIM/ .

More information about the Minnesota Accountable Health Model can be found at: http://mn.gov/health-reform/health-reform-in-Minnesota/index.jsp.

Procedures and Instructions for Responding

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Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

To be assured consideration, comments must be received no later than 7:00 PM CST on October 15, 2013.

Please e-mail an electronic copy of your responses to SIM@state.mn.us. Use the subject line: “RFI: SIM Data and HIT Infrastructure.” Attachments should be in Adobe PDF or Microsoft Word format.

Respondents are responsible for all costs associated with the preparation and submission of responses to this RFI. All responses to this RFI are public, according to Minnesota Statutes § 13.03 unless otherwise defined by Minnesota Statutes § 13.37 as “Trade Secrets.” If the Responder submits information that it believes to be trade secret/confidential materials, and the Responder does not want such data used or disclosed for any purpose other than the evaluation of this Response, the Responder must clearly mark every page of trade secret materials in its Response at the time the Response is submitted with the words “Trade Secret” or “Confidential,” and must justify the trade secret designation for each item in its Response. If the State should decide to issue an RFP and award a contract based on any information received from responses to this RFI, all public information, including the identity of the responders, will be disclosed upon request.

RFI QUESTIONS

Section A: Increasing Participation in Accountable Care Models

1. What types of health information technology investments, tools or resources would you require or wish to leverage in order to position your organization to participate in accountable care models? Type here to enter text.

2. What role should state agencies play in encouraging and supporting the availability and use of these tools? Type here to enter text.

3. What types of provider partnerships would be most effective in improving quality of care and lowering costs? To what extent is health information technology infrastructure and data exchange a barrier to such partnerships?Type here to enter text.

4. What are the major challenges or barriers to forming meaningful partnerships between ACOs and non-clinical community services and neighborhood-based agencies to facilitate coordinated care and promote healthier conditions in patients’ lives? Type here to enter text.

Section B: e-Health Community Collaboration Grants and Technical Assistance Needs

The SIM team is considering awarding grants to community collaboratives and awarding contracts to provide technical assistance to help communities and providers implement models for coordinated care utilizing health information technology and health information exchange. This will assist in the process of becoming a participant in or partner with an Accountable Care Organization or similar model, or developing readiness to do so in the future. In terms of prioritizing these investments, the initial SIM priority settings have been identified as: long-term care, local public health, behavioral health, and social services. Resources and support will be focused on projects that include some or all of these priority settings and organizations. The

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Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

program may provide “development grants” and “implementation grants.” In addition to development and implementation grants, technical assistance would be provided through one or more contracts.

Development grants would be awarded for development of collaboratives, governance structures and plans for use of health information exchange and health information technology to support participate in an accountable community for health.

Implementation grants would be awarded for implementation of collaboratives, governance structures and plans for use of health information exchange and health information technology to support participate in an accountable community for health.

Technical assistance contract(s) would be awarded to develop and disseminate tools and resources to promote electronic health record adoption and effective use in the priority settings of long-term care, local public health, social services, and behavioral health to support participation in the community collaborative grant program and in accountable care models. Technical assistance would include developing and/or identifying tools and resources through building community consensus to create and implement setting-specific Minnesota e-health roadmaps. Technical assistance would also be provided in the area of privacy and security.

Details of these programs are still being finalized, but it is anticipated that one or more Requests for Proposals would be released by first quarter of 2014 to support this effort. The questions below will inform key programmatic decisions for these activities.

1. To provide coordinated care improve the patient health care experience, and lower costs, what information/data is needed? For example, as a provider (e.g., serving in a clinic, hospital, long-term care, local public health, behavioral health, or social services setting), what types of clinical and health-related information do you need about your patients in order to better manage their care ? Please provide specific examples whenever possible.Type here to enter text.

2. What are the challenges and considerations for achieving the goals of the SIM grant related to health information technology and health information exchange in the priority settings of long-term care, local public health, behavioral health, and social services? Please describe details in the following areas:

Organizational support (i.e., internal or external policy, training, leadership, workforce, standards)Type here to enter text.

Workflow issues (e.g., ability to effectively use health information at the point of care) Privacy and security issuesType here to enter text. Other legal issues (not privacy or security, e.g., data sharing agreements, contracting) Technical Infrastructure (e.g., EHRs, hardware, software, broadband, HIE availability,

EHR certification criteria)Type here to enter text. Capabilities of desired health information exchange partnersType here to enter

text. Financing issues Type here to enter text.

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Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

Data quality issuesType here to enter text. Other (e.g., competing priorities such as ICD-10)Type here to enter text. If possible, please also rank the challenges in order of priority.

3. Specific to long-term care, social services and behavioral health organizations, are there existing models of secure health information exchange with hospitals/clinics or other medical providers that the state should draw upon in designing investments and support?Type here to enter text.

4. What types of resources (financial, technical assistance, other) are currently available to support the SIM priority settings of long-term care, local public health, behavioral health, and social services in exchanging clinical data to support coordinated care? Please provide links to resources and contact information if available.Type here to enter text.

5. What types of technical assistance will be needed for achieving the goals of the SIM grant related to health information exchange in the priority settings of long-term care, local public health, behavioral health, and social services? Please describe technical assistance needs in the following areas:

Organizational support (i.e., internal or external policy, training, leadership, workforce, standards)Type here to enter text.

Workflow issues (e.g., ability to effectively use health information at the point of care)Type here to enter text.

Privacy and security issuesType here to enter text. Other legal issues (not privacy or security, e.g., data sharing agreements,

contracting)Type here to enter text. Technical Infrastructure (e.g., EHRs, hardware, software, broadband, HIE availability,

EHR certification criteria)Type here to enter text. Capabilities of desired health information exchange partnersType here to enter

text. Financing issuesType here to enter text. Data quality issuesType here to enter text. Other (e.g., competing priorities such as ICD-10)Type here to enter text. If possible, please also rank the technical assistance needs in order of priority.

6. In order to achieve the goals of SIM related to health information exchange with priority settings, how should community collaborative grants be structured? Considerations include, but are not limited to:

a. Size of grants – financial needsType here to enter text.b. Size of grants – community size or population servedType here to enter text.c. Balance between planning and implementationType here to enter text.d. Settings necessary for inclusion (e.g., beyond the four SIM priority setting areas)Type

here to enter text.e. Eligible grant applicants/recipientsType here to enter text.f. Activities that should be funded by the grantType here to enter text.g. Activities that should be required of grant recipientsType here to enter text.

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Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

h. Activities that should not be funded by the grantType here to enter text.i. Outcomes that should be measuredType here to enter text.

7. Federal meaningful use requirements have identified the following priority health information exchange transactions:

E-Prescribing services (transmit, eligibility, formulary) Type here to enter text. Electronic reporting of immunizations to MDH Type here to enter text. Electronic submission of reportable lab results to MDHType here to enter text. Electronic submission of cancer cases to MDH (ambulatory settings only) Type here to

enter text. Syndromic surveillance Type here to enter text. Laboratory data transactions Type here to enter text. Electronic clinical laboratory test ordering Type here to enter text. Electronic laboratory results delivery Type here to enter text. Reporting of clinical quality measures to CMS Type here to enter text. Transitions of Care / Consolidated CDA Type here to enter text. Consumer access to information (view, download, transmit) Type here to enter text. Patient – provider communicationsType here to enter text.

a. Which, if any, of the above priority health information exchange transactions should be targeted by SIM health information technology/exchange grants? Are there certain meaningful use transactions that should not be considered priority transactions for achieving the goals of the Minnesota Accountable Health Model and SIM? Why or why not?Type here to enter text.

b. What additional transactions should be considered for achieving the goals of the Minnesota Accountable Health Model and SIM related to health information exchange? For example, is there a need for automated alerting in your community (e.g., alerting the health care home on emergency department visits or hospital admission)? Are there current standards recommended for these additional transactions?Type here to enter text.

8. In regard to privacy and security, the following topics have been identified where additional education or resources may be needed:

Overall understanding of Minnesota and federal privacy and security laws Consumer knowledge about how their health information is used, including use and

disclosure of electronic protected health information Guidance for creating audit logs for access to patient records Security risk assessments HIPAA Omnibus changes Minor consent State and federal laws related to the management of an individual’s electronic protected

health information Granular consent management Mobile health Privacy considerations for interstate HIE and HIE with tribes

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Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

a. For which of the above topics is there the greatest need for education or technical assistance, from your perspective? Type here to enter text.

b. Are there additional privacy and security topics that should be considered for the development of education or technical assistance?Type here to enter text.

c. What types of resources, education, or technical assistance would be most beneficial for each topic, from your perspective?Type here to enter text.

d. In what format would you prefer to receive education or technical assistance (in-person, webinar, white papers or toolkits, other)?Type here to enter text.

Section C: Data Analytics

In an effort to support Minnesota’s accountable health model through the SIM grant, the state is also considering contracting with vendor solutions for data analytic support and technical assistance to providers currently in or desiring to be in accountable care organizations or similar models.

The following are health information infrastructure components required to support an ACO where additional education or resources may be needed:

a. Aligning or reconciling the format, timing or content of data analytic streams coming from different payers

b. Integrating data from claims/administrative, clinical and operational system sources – including that which occurs outside your organization

c. Monitoring and performance reporting d. Using data analytics to identify opportunities for cohort management or patient

engagement in caree. Access and dissemination of information for care coordinationf. Interpreting and applying risk information g. Making the data “actionable”/using and applying data analytics at the point of care h. Other? (please elaborate in questions below)

1. Which of the above topics do you find the most challenging and why? How would you rank the above components in order of highest to lowest priority?Type here to enter text.

2. Of the components mentioned above or others you can identify, for which would you find technical assistance most valuable? What form of assistance would be most useful?Type here to enter text.

3. Of the components described, for which, if any, would you consider using a shared or common tool with other providers or ACOs? For example, if the state coordinated with a single vendor that could integrate clinical and administrative data for reporting, would you leverage this vendor?Type here to enter text.

4. What role do health plans and payers play in managing and performing the analytics associated with accountable care organizations? Which of the components or activities listed above can or should be provided by payors? Type here to enter text.

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Health Information Technology and Data Analytics in Accountable Care Models

5. Recognizing that SIM or other government funding streams may be time limited, what mechanisms (such as provider subscription) exist for ongoing funding and support of common tools?Type here to enter text.

6. In what ways might the state align its data analytic feeds with those that providers receive from other payors with which they contract? What are the main areas of difference between these data analytic feeds? To what extent would alignment improve the ability of providers to manage care for their populations?Type here to enter text.

Section D: Other1. Provide any additional comments that you think would be helpful for the State in making the

determination for funding priorities and achieving the goals of the SIM grant in the areas of ACO expansion, health information technology and health information exchange with long term care, local public health, behavioral health and social services, and data analytics. Type here to enter text.

Section E: Respondent Information

1. Respondent NameType here to enter text.2. Respondent Organization NameType here to enter text.3. The role of the Respondent (e.g., provider, administrator, payer, etc.)Type here to enter text.4. A brief description of organization’s current HIT capabilities and investments (e.g., does the

organization have an EHR in place, is the organization participating in meaningful use, is the organization exchanging the majority of claims and other administrative transactions electronically?)Type here to enter text.

Thank you for taking the time to respond to this RFI. Your input is appreciated and important to the success of Minnesota’s SIM grant.

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Minnesota State Innovation Model GrantRequest for Information on

Health Information Technology and Data Analytics in Accountable Care Models

Glossary of Terms – Working Definitions

The list below includes a set of working definitions for terms used throughout this RFI. Most terms have more than one possible definition. Comments are also accepted on improvements to the following terms or alternative sources for the working definitions.

Accountable Care Organizations (ACOs)

This term is used throughout this RFI to represent the notion of a group of health care providers with collective responsibility for patient care that helps providers coordinate services—delivering high-quality care while holding down costs.

The term is derived from a definition by the Robert Wood Johnson Foundationwww.rwjf.org/en/topics/search-topics/A/accountable-care-organizations-acos.htmlAccessed 09.10.13

Behavioral Health

The term “behavioral health” is a general term that encompasses the promotion of emotional health; the prevention of mental illnesses and substance use disorders; and treatments and services for substance abuse, addiction, substance use disorders, mental illness, and/or mental disorders. Behavioral health includes the identification, treatment of, and recovery from mental health and substance use disorders. It also increasingly refers to lifestyle changes and actions which improve physical and emotional health, as well as the reduction or elimination of behaviors which create health risks.

Care Coordination

Care Coordination involves two different but related aspects of patient care. One provides information to the clinician who must be able to access from and provide relevant data to multiple sources in order to determine and provide for appropriate next steps in diagnosis or treatment. The other is to assure that patients are in the appropriate setting as they transition among multiple levels of care. Both are important for providing high quality care as well as mitigating excess, both must incorporate patient needs and preferences, and both are highly dependent on the ability to quickly and easily send and query health information on a given patient to and from multiple electronic sources.

A Health IT Framework for Accountable CareCCHIT- 2013 (pg. 12)https://www.cchit.org/hitframework Accessed 09.10.13

Electronic Health Records (EHR)

EHR is a real-time patient health record with access to evidence-based decision support tools that can be used to aid clinicians in decision-making. The EHR can automate and streamline a clinician's workflow, ensuring that all clinical information is communicated. It can also prevent delays in response that result in gaps in care. The EHR can also support the collection of data for uses other than clinical care, such as billing, quality management, outcome reporting, and public health disease surveillance and reporting. An EHR is considered more comprehensive than the concept of an Electronic Medical Record (EMR). Reference: http://www.hhs.gov/healthit/glossary.html

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Health Information Technology and Data Analytics in Accountable Care Models

MN e-Health Glossarywww.health.state.mn.us/e-health/e.htmlAccessed 09.10.13

Health Care Delivery System (HCDS)

In 2008 Minnesota passed health care legislation to improve affordability, expand coverage and improve the overall health of Minnesotans. In addition, the 2010 Legislature mandated the Minnesota Department of Human Services (DHS) to develop and implement a demonstration testing alternative and innovative health care delivery systems, including accountable care organizations. DHS will contract with delivery systems as voluntary demonstration sites that will be paid under alternative arrangements. Demonstration sites will include Minnesota Health Care Programs (MHCP) fee-for-service recipients and managed care enrollees and support a robust primary care model and improve care coordination (e.g. health care homes) for recipients.

Department of Human Serviceswww.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_161441 Accessed 09.10.13

Health Care Home

A "health care home," also called a "medical home," is an approach to primary care in which primary care providers, families and patients work in partnership to improve health outcomes and quality of life for individuals with chronic health conditions and disabilities.

Minnesota Department of Healthwww.health.state.mn.us/healthreform/homes/Accessed 09.10.13

Health Information Exchange (HIE)

Health information exchange or HIE means the electronic transmission of health related information between organizations according to nationally recognized standards [Minn. Stat. §62J.498 sub. 1(f)]. Reference: https://www.revisor.mn.gov/statutes/?id=62J.498

MN e-Health Glossarywww.health.state.mn.us/e-health/h.html Accessed 09.10.13

Health Information Technology (HIT)

HIT is the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making. Reference: http://www.hhs.gov/healthit/glossary.html

MN e-Health Glossarywww.health.state.mn.us/e-health/h.html Accessed 09.10.13

Local Public Health

Local public health in Minnesota is provided through Community Health Boards and Tribal Governments. Local public health departments partner with multiple systems including schools, law enforcement, social services, municipalities, non-profits and private health care providers to coordinate high quality, non-duplicative programs.

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Long-Term Care

Long-term care is defined as “a variety of services and supports to meet health or personal care needs over an extended period of time” intended to help a person maximize independence and functioning.

U.S. Department of Health and Human Services, National Clearinghouse for Long-Care Information “Understanding LTC” www.longtermcare.gov

Population Health

A definition of population health is: an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health inequities among population groups. Population health seeks to step beyond the individual-level focus of mainstream medicine and public health by addressing a broad range of factors that impact health on a population level, such as environment, social structure, resource distribution, etc. An important theme in population health is importance of social determinants of health and the relatively minor impact that medicine and healthcare have on improving health overall.

Population health is “everyone’s responsibility” in contrast to public health which is the “governmental responsibility” for the health of a population. Public health is concerned with threats to the overall health of a community based on population health analysis. Governmental public health agencies provide the backbone to the public health infrastructure, but this infrastructure is also dependent on other entities such as the health care delivery system, the public health and health sciences academia, and other sectors that are heavily engaged and more clearly identified with health activities. Public health also plays a legal regulatory role (e.g., conducting restaurant inspections).

MDH e-Health Glossarywww.health.state.mn.us/e-health/p.html Accessed 09.11.13

Provider For purposes of this RFI, the term “provider” is meant to include the broad notion of health care professionals within medicine, nursing, behavioral health, or allied health professions. Health care providers may also be a public/community health professional. Institutions include hospitals, clinics, primary care centers, long term care organizations, mental health centers, and other service delivery points.

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Public Health Public health is concerned with threats to the overall health of a community based on population health analysis. Reference: http://en.wikipedia.org/wiki/Public_healthandGovernmental public health agencies provide the backbone to the public health infrastructure, but this infrastructure is also dependent on other entities such as the health care delivery system, the public health and health sciences academia, and other sectors that are heavily engaged and more clearly identified with health activities. Public health also plays a legal regulatory role (e.g., conducting restaurant inspections). Reference: Adapted from the Institute of Medicine.

MDH e-Health Glossarywww.health.state.mn.us/e-health/p.html

Access 09.11.13Social Services The system of programs, benefits and services made available by public, non-

profit or private agencies that help people meet those social, economic, educational, and health needs that are fundamental to the well-being of individuals and families. Examples of social services, for the purposes of this RFI, include but are not limited to organizations that provide housing, transportation, or nutritional services to individuals or families.

Triple Aim The Triple Aim is a framework developed by the Institute for Healthcare Improvement (IHI) that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

Improving the patient experience of care (including quality and satisfaction);

Improving the health of populations; and Reducing the per capita cost of health care.

The IHI Triple Aimwww.ihi.org/offerings/Initiatives/TripleAim/Pages/default.aspx

Accessed 09.10.2013

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