Breaking down the Triple Aim

April 29, 2016
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MultiCare Connected Care is an accountable care organization (ACO). But what does “accountable” really mean and who is being held accountable for what?

The answer begins with the Triple Aim. Developed by the Institute for Healthcare Improvement (IHI) in 2007, the Triple Aim is a framework for health care providers to improve performance in the areas that matter most to patients and consumers of health care:

  1. Improving the patient experience of care.
  2. Improving the health of populations.
  3. Reducing the per capita cost of health care.

Throughout the U.S., the Triple Aim framework is being adopted as an instrument for health care reform by many ACOs and other innovative entities, including MultiCare Connected Care.

Why the Triple Aim?

The United States health care system is the most costly in the world, accounting for 17 percent of the gross domestic product. And as health care costs continue to rise, aging populations, increased longevity and chronic health problems are placing new demands on medical and social services – not just nationally but also globally.

Yet health care delivery is often fragmented, leaving the patient responsible for navigating the system and coordinating services, which are frequently duplicated.

In most health care settings today, no one party is accountable for all three dimensions of the Triple Aim. ACOs like MultiCare Connected Care seek to change that – for the health of our communities.

How is the Triple Aim implemented by MultiCare Connected Care?

As providers within the MultiCare Connected Care Network strive to achieve better clinical outcomes and patient experience at a more affordable cost, they are held accountable by purchasers of health services, such as insurance companies and employers.

Here‘s one way this works:

  1. First, MultiCare Connected Care provides high-quality care and service in a way that costs less than before.
  2. The financial savings generated by these activities are held back by the purchaser. A portion of these savings are returned to MultiCare Connected Care if providers meet pre-agreed-on quality and service performance targets.
  3. If MultiCare Connected Care achieves savings but not the quality and service targets for a given population, the purchaser (health insurance company or employer that funds health benefits for its employee population) saves money, but the health of that population may not improve (or may worsen). MCC doesn't receive any of the savings and is unable to reinvest that revenue in services and facilities necessary to keep pace with the needs of the population.
  4. If MultiCare Connected Care doesn't achieve savings, then there is no money to earn back even if we meet our quality and service targets. This makes it even harder to reinvest in the services necessary to care for the population.

So this is how our ACO is held accountable for achieving all aspects of the Triple Aim. Performing well in just one or two areas of the Triple Aim is not sustainable. We must excel at all three, all the time, to continue to deliver on our care promises to our communities for many years to come.

In upcoming blog posts, we'll explain how the three aspects of the Triple Aim – quality, service and cost savings – are implemented and measured at MultiCare Connected Care, and explore some recent successes in those areas.
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