The Triple Aim Framework

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The Triple Aim framework outlines some specific methods that participating organizations can use to reduce per capita healthcare costs. Triple Aim initiative can assist their participants in reducing their costs by creating and streamlining organizational efficiencies. Frequently experienced unnecessary wastes like delivery of inappropriate health care services, inefficient organizational processes, unneeded administration costs, and lack of preventive service opportunities can be prevented by following Triple Aim initiatives. Organizations should not only focus on specific things but should try and reduce all types of costs by aligning their payment and system resources towards maintaining the Triple Aim initiatives and goals (The Commonwealth…show more content…
Healthcare policies also play a vital role in bending the cost curve, and these healthcare policies should promote affordable healthcare coverage while reforming healthcare payment systems and investing in technology. In this case study series illustrated by the Commonwealth Fund, CareOregon, Genesys Health System, and QuadMed are the organizations that are used as examples for successful implementation of Triple Aim initiative. It is important to examine each of these health systems processes to learn their strategies to bend the cost curve. Triple Aim Design Principles promote cost control by: " Assuring that payment and resource allocation support Triple Aim goals. " Introducing yearly initiatives to reduce waste like achieving a target of < 3% inflation yearly for per capita cost by developing cooperative relationships with physician groups and other healthcare organizations committed to reducing the waste of healthcare resources. " Rewarding providers for their contribution to producing better health for the population and not just producing more health…show more content…
UPMC health plan is one of the Triple Aim sites in the Phase IV process of this initiative. UPMC had partnered with their community of providers through their Patient-centered medical homes and followed the strategy of Team-Based Care to achieve the goal of Triple Aim framework. UPMC was recognized for high quality and innovation in 2013 and was awarded Best customer experience award by the International Customer Management Institute (ICMI). UPMC focused on People, Process, and Technology to unleash the power of an integrated system. This health plan supports medical home model with virtual teams and community resources. They focus on aligning their measures with the financial incentives so that their providers are continuously motivated. With the implementation of Triple Aim initiatives UPMC health plan was able to reduce Medical, Pharmacy and total costs while improving HEDIS measured quality measures at the same time. They were able to reduce total medical expense Per Member Per Month (PMPM) by 20% between 2011 and 2013, and improved medical expense ratio from 92.1% in 2012 to 82.3% in 2013 (Redmond, 2014). In order for meaningful change to occur in any organization, it is paramount that local providers and healthcare agencies are all engaged and

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