5 principles to help hospital leaders improve on the Triple Aim

Hospital leaders have proposed a new set of care principles to reflect the post-Affordable Care Act (ACA) healthcare landscape, according to an opinion piece in JAMA co-written by former Centers for Medicare & Medicaid Services Administrator Donald Berwick.

Several major healthcare organizations, including Intermountain Healthcare, Kaiser Permanente, Contra Costa Health Services and HealthPartners, have formed a Leadership Alliance aimed at helping one another, patients and communities achieve the Triple Aim of lower costs, improved patient experience and improved outcomes, according to Berwick and his coauthors, Derek Feeley and Saranya Loehrer, M.D.

Public and private providers have taken steps to accelerate changes in care delivery structures, such as the proliferation of accountable care organizations and bundled payment contracts, but the challenge for the future is to maintain changes within the healthcare system so that they actually result in improvements in outcomes.

The Leadership Alliance's goals are based on, but not limited to, those in the 2001 Institute of Medicine Report, Crossing the Quality Chasm, which identifies six areas in which healthcare must improve: equity, efficiency, timeliness, patient-centeredness, effectiveness and safety. Achieving these outcomes, they write, will mean a new set of design principles, which include the need to:

  • Alter the balance of power to make patients, communities and families partners in the process of improving health and well-being
  • Reduce waste and use all resources to their fullest extent
  • Eliminate silos and institutional/professional boundaries
  • Use money saved to improve care delivery for other public and private needs, with an overall goal of expenditures at or under 15 percent of gross domestic product
  • Develop systems that welcome change while continually pursuing improved outcomes

The intent of the alliance is "not to defend the status quo, or to argue for new resources in a U.S. healthcare system that already consumes far too much," the authors write. "Rather, its members will together promise to deliver, in concert with their communities, better care and better health at continually lower cost per capita, and to show others how."

To learn more:
- read the piece