North Star
Guiding Principles
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01. Outcomes over activity
Pay for what genuinely produces results, not just what gets billed. We focus on actions that lead to real health improvements, such as achieving control, remission, improved function, and avoiding harm. We evaluate the total cost of care, not just individual prices. Interventions that cannot show improvements in outcomes or cost-effectiveness are given lower priority.
This shifts incentives for all parties. Employers and purchasers ensure outcome guarantees; providers and solutions focus on meaningful clinical goals; dashboards monitor the differences. When funds are linked to outcomes, wasteful volume no longer gets support.
02. Buyer power, patient dignity
Purchasers need clear, simple signals to guide spending on value; patients need transparency, access, and respect. We make complex analytics easy to understand at the point of decision.
The result is fewer dead ends and unexpected bills. People access appropriate care more quickly; buyers negotiate based on data, not hype. Dignity shows in shorter waits, clearer bills, and better care.
03. Open methods, no black boxes
Every metric, code set, and algorithm behind the Index and Certification are published, versioned, and auditable. Anyone can see the numerator, denominator, risk adjustment, and thresholds.
Open methods build trust and speed up adoption. They allow buyers to compare options fairly, enable vendors to improve according to clear standards, and make cheating harder because the community can review and improve.
04. Primary-care first
Access and continuity in primary care are crucial for both health outcomes and affordability. We focus on initiatives that improve first-contact, comprehensive care, and coordinated referrals.
When primary care is strong, chaos downstream decreases—fewer unnecessary ED visits, better management of chronic conditions, and better prescribing behavior. Contracts and benefits should ensure primary care is easy to access and hard to avoid.
05. Market standards, not mandates
Clear, credible standards influence markets more quickly than wishful thinking. The Index and Certification make responsible spending transparent, allowing buyers to demand it in RFPs.
Standards allow good actors to succeed based on merit. They decrease friction in contracting, align vendors with standard definitions, and reward those who deliver results at a fair price without waiting for new laws.
06. Equity by design
Every measure is broken down by race/ethnicity, age, geography, and income proxy. We reveal the gaps and set milestones to close them because averages hide issues.
Equity is not a side project, it’s a performance requirement. Certification favors solutions that clearly close gaps; dashboards show progress and enforce timelines, not slogans.
Read more about our position on Health Equity
07. Relentless simplification
Complexity generates waste. We streamline benefit rules, data specifications, and workflows so that doing the right thing is the simplest choice.
Every extra click, prior authorization process, or custom file layout undergoes a thorough cost–benefit analysis. If it doesn’t improve outcomes or affordability, we remove it or replace it with a simpler approach.
08. Non-political ideology
Ten Ten Ten is practical, not partisan. We publish open methods, verify results, and make progress public. Our test is simple: does it improve outcomes, expand access, and cut total cost without sacrificing safety or equity?
All Americans, regardless of their political affiliation, want timely and safe care, clear pricing, and fair bills. Shared facts build a big-tent coalition. No one wants to pay more for less. Polarizing labels like Red America and Blue America are not welcome at Ten Ten Ten.
09. Radical transparency
Progress, warts and all, should be shared openly. Dashboards show trends in outcomes, affordability, access, and equity, along with the methods employed to reach these results
Transparency shifts power. Buyers negotiate with facts, communities understand their positions, and leaders can’t hide behind averages. Sunlight accelerates what works and eliminates what doesn’t.
10. Privacy & safety
We prioritize privacy by design, using de-identified or aggregated data for public reporting, implementing least-privilege access controls, and conducting independent security assessments. Mandatory clinical safety protocols and escalation procedures are in place.
Trust is crucial. If people can’t rely on us to protect their data and keep them safe, nothing else matters. Our certification tests are both more effective and affordable because quality care must also be safer and cost-effective. Review our Privacy Policy