Pursuing the Triple Aim: The First 7 Years.

Publisher: Blackwell Publishers Country of Publication: United States NLM ID: 8607003 Publication Model: Print Cited Medium: Internet ISSN: 1468-0009 (Electronic) Linking ISSN: 0887378X NLM ISO Abbreviation: Milbank Q Subsets: MEDLINE

Publication: Malden, MA : New York, NY : Blackwell Publishers ; Milbank Memorial Fund
Original Publication: New York, NY : Published for the Milbank Memorial Fund by Cambridge University Press, c1986-

Delivery of Health Care, Integrated/*organization & administration ; Health Benefit Plans, Employee/*organization & administration ; Public Health/*standards ; Quality Assurance, Health Care/*standards ; United States Indian Health Service/*organization & administration; Community-Institutional Relations ; Cost Control/legislation & jurisprudence ; Cost Control/methods ; Cost Control/standards ; Delivery of Health Care, Integrated/economics ; Delivery of Health Care, Integrated/standards ; Health Benefit Plans, Employee/economics ; Health Benefit Plans, Employee/standards ; Health Plan Implementation/economics ; Health Plan Implementation/methods ; Health Plan Implementation/organization & administration ; Humans ; Needs Assessment ; Organizational Case Studies ; Outcome Assessment, Health Care/methods ; Outcome Assessment, Health Care/statistics & numerical data ; Patient Protection and Affordable Care Act ; Patient Satisfaction ; Public Health/economics ; Public Health/legislation & jurisprudence ; Quality Assurance, Health Care/economics ; Quality Assurance, Health Care/legislation & jurisprudence ; United States ; United States Indian Health Service/economics ; United States Indian Health Service/standards ; Wisconsin

Unlabelled: POLICY POINTS: In 2008, researchers at the Institute for Healthcare Improvement (IHI) proposed the Triple Aim, strategic organizing principles for health care organizations and geographic communities that seek, simultaneously, to improve the individual experience of care and the health of populations and to reduce the per capita costs of care for populations. In 2010, the Triple Aim became part of the US national strategy for tackling health care issues, especially in the implementation of the Patient Protection and Affordable Care Act (ACA) of 2010. Since that time, IHI and others have worked together to determine how the implementation of the Triple Aim has progressed. Drawing on our 7 years of experience, we describe 3 major principles that guided the organizations and communities working on this endeavor: creating the right foundation for population management, managing services at scale for the population, and establishing a learning system to drive and sustain the work over time.
Context: In 2008, researchers at the Institute for Healthcare Improvement (IHI) described the Triple Aim as simultaneously "improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations." IHI and its close colleagues had determined that both individual and societal changes were needed.
Methods: In 2007, IHI began recruiting organizations from around the world to participate in a collaborative to implement what became known as the Triple Aim. The 141 participating organizations included health care systems, hospitals, health care insurance companies, and others closely tied to health care. In addition, key groups outside the health care system were represented, such as public health agencies, social services groups, and community coalitions. This collaborative provided a structure for observational research. By noting the contrasts between the contexts and structures of those sites in the collaborative that progressed and those that did not, we were able to develop an ex post theory of what is needed for an organization or community to successfully pursue the Triple Aim.
Findings: Drawing on our 7 years of experience, we describe the 3 major principles that guided the organizations and communities working on the Triple Aim: creating the right foundation for population management, managing services at scale for the population, and establishing a learning system to drive and sustain the work over time.
Conclusions: The concept of the Triple Aim is now widely used, because of IHI's work with many organizations and also because of the adoption of the Triple Aim as part of the national strategy for US health care, developed during the implementation of the Patient Protection and Affordable Care Act of 2010. Even those organizations working on the Triple Aim before IHI coined the term found our concept to be useful because it helped them think about all 3 dimensions at once and organize their work around them.
(© 2015 Milbank Memorial Fund.)

MedGenMed. 2001 Mar 05;3(2):2. (PMID: 11549951)
Soc Sci Med. 1990;31(12):1347-63. (PMID: 2126895)
Qual Saf Health Care. 2002 Dec;11(4):345-51. (PMID: 12468695)
Health Aff (Millwood). 2002 Mar-Apr;21(2):78-93. (PMID: 11900188)
Prev Chronic Dis. 2010 Jul;7(4):A71. (PMID: 20550829)
Minn Med. 2012 Nov;95(11):37-9. (PMID: 23243752)
Health Aff (Millwood). 2008 May-Jun;27(3):759-69. (PMID: 18474969)
Public Health. 2013 Jun;127(6):503-13. (PMID: 23725680)
BMJ Qual Saf. 2011 Apr;20 Suppl 1:i87-91. (PMID: 21450781)
Jt Comm J Qual Improv. 2000 Jun;26(6):321-31. (PMID: 10840664)
PLoS Med. 2008 Mar 11;5(3):e67. (PMID: 18336067)
Milbank Q. 2011 Jun;89(2):167-205. (PMID: 21676020)

Keywords: Triple Aim; population management; populations

Date Created: 20150606 Date Completed: 20150810 Latest Revision: 20240323

20240323

PMC4462878

10.1111/1468-0009.12122

26044630