Triple Aim Approach To Managed Care

Healthcare reform of 2010 changed the way health systems regard success. The Patient Protection and Affordable Care Act forced providers and insurance companies to increase access for various forms of treatment to all Americans. It reemphasized accountability in a country that spends 18 percent of its gross domestic product on health expenditures, yet ranks near the bottom of developed countries in numerous health categories (Coyne et al, 2014). This recent policy strains resources and funding to a tipping point. Therefore, the nation’s health systems must create innovative and adaptive techniques to handle the stress on their journey to achieve the Triple Aim goal. In 2007, the Institute for Healthcare Improvement developed the Triple

The current market behaviors and gross, resource wastefulness is to blame for a majority of inefficiencies. In addition, each goal of the TA method may affect another adversely if consideration of the big picture is lacking. McCarthy and Klein (2010) illustrate “without balanced attention to these three overarching aims, health care organizations may increase quality at the expense of cost or they may decrease cost while creating a dissatisfying experi¬ence for patients” (p. 1). With the push of ACA and the Triple Aim approach, local governments expect collaboration between providers in order to properly utilize resources and reduce the increasing incidence and cost of healthcare. An Accountable Care Organization (ACO) is part of healthcare reform requiring mutual support from several health facilities in a defined region. They share responsibility for community health and the financial risk of increasing access while forming networks that are more efficient. A regulatory board that evaluates performance and delivers incentives will monitor success. The ACO model and collaborative care is vital for achievement of the TA

Instead, a majority of health professions schools today show a collection of mutually-exclusive educational structures and affiliated practice organizations with little dialogue, integration, or collaboration between them (Earnest and Brandt, 2014). Moreover, academic curriculum lacks direction for developing cooperative abilities. Earnest and Brandt (2014) reveal “inter-professional team-based care, quality and process improvement, and population health management are not skills that have been emphasized in traditional health professions education and training” (p. 497). This lack of understanding only leads to a lack of