Reaching the Quintuple Aim
The Quintuple Aim is the next evolution in healthcare transformation. Building on the Triple and Quadruple Aims, it adds health equity as a fifth pillar—recognizing that improving outcomes and reducing costs cannot be achieved without addressing disparities in care delivery.7
For Accountable Care Organizations (ACOs), the Quintuple Aim offers a comprehensive framework to guide performance, strategy, and innovation. The five aims are:
1. Improved Patient Experience
2. Better Population Health
3. Lower Per Capita Costs
4. Enhanced Provider Well-being
5. Health Equity
Why the Quintuple Aim Matters
The COVID-19 pandemic exposed deep inequities in healthcare access and outcomes. Marginalized populations experienced higher rates of infection, mortality, and care disruption.6 The Quintuple Aim responds to this reality by embedding equity into every aspect of care.
Recent CMS initiatives, including ACO REACH and Primary Care Flex, emphasize equity, care coordination, and provider support.3
Why Health Equity Is the New Imperative
Health equity was added to the Quintuple Aim because persistent disparities in outcomes, access, and quality of care have become too significant to ignore. Racial and ethnic minorities, low-income populations, and rural communities experience:
– Higher rates of chronic disease (e.g., diabetes, hypertension, asthma)
– Lower access to preventive services and primary care
– Greater barriers to care due to cost, transportation, and systemic bias.2
Black patients with diabetes are hospitalized at rates 2.5 times higher than White patients yet are less likely to receive newer medications or technologies.2 In Medicare populations, dual-eligible beneficiaries face significantly worse outcomes and higher costs, prompting CMS to introduce health equity adjustments in payment models.4
The economic cost of health disparities is also staggering. A Deloitte analysis estimates that inequities cost the U.S. healthcare system $320 billion annually, and could exceed $1 trillion by 2040.5
How BettrAI Supports the Quintuple Aim
BettrAI’s AI-powered platform helps ACOs meet each aim through:
1. Improved Patient Experience
– Virtual Health Assistant Sophie engages patients between visits, improving satisfaction and reducing missed follow-ups.
– Real-time dashboards track engagement and care gaps.
2. Better Population Health
– Predictive analytics identify rising-risk patients before complications occur.
– Integrated care pathways support chronic disease management and preventive care8.
3. Lower Per Capita Costs
– Early intervention reduces avoidable ED visits and hospitalizations.
– ACOs using BettrAI have reported 20% reductions in preventable hospitalizations.
4. Enhanced Provider Well-being
– Automation of documentation and outreach reduces administrative burden.
– BettrAI helps mitigate burnout, which affects 43.2% of clinicians in ACOs.
5. Health Equity
– Stratified patient data by race, ethnicity, income, and geography to identify disparities.
– Automated outreach to underserved populations through tools like Sophie.
– Integration of SDOH insights into care plans to tailor interventions.
– Support for CMS equity reporting and ACO REACH requirements.
Key Takeaway
The Quintuple Aim is not just a framework—it’s a mandate. ACOs that embrace technology, data, and equity-driven strategies are better positioned to deliver smarter, more inclusive care.
BettrAI empowers ACOs to operationalize the Quintuple Aim—turning vision into measurable impact.
References
- AHRQ. Emergency Department Utilization Reduction. https://www.ahrq.gov
- Blue Shield of California Foundation. Identifying and Managing Patients at Risk for High Utilization. JSI Research & Training Institute; 2018. https://blueshieldcafoundation.org/sites/default/files/covers/JSI%20Rising%20Risk%202018.pdf
- CMS. CMS Moves Closer to Accountable Care Goals with 2025 ACO Initiatives. https://www.cms.gov/newsroom/fact-sheets/cms-moves-closer-accountable-care-goals-2025-aco-initiatives
- CMS. Health Equity Adjustment in Medicare Payment Models. https://www.cms.gov
- Deloitte. The Economic Cost of Health Disparities. https://www2.deloitte.com
- Dzau VJ, Mate KS, O’Kane M. Equity and Quality—Improving Health Care Delivery Requires Both. JAMA. 2022.
- Nundy S, Cooper LA, Mate KS. The Quintuple Aim for Health Care Improvement: A New Imperative to Advance Health Equity. JAMA. 2022;327(6):521–522. https://jamanetwork.com/journals/jama/fullarticle/2788483