Triple Aim Approach: A Case Study

The U.S. Health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance.” (WHO, 2000, p. 1) Progression in the United States has not kept up with the advances in other wealthy nations dealing with the population health. Disease and chronic disability report almost 50% of America health problem (JAMA, 2013).

Increasing healthcare costs without a corresponding increase in health outcomes is something the United States has been dealing with for years. In fact, it is estimated that thousands of individuals die every year due to errors (To Err is Human, 2000). Finding a way to reign in those costs and increase health outcomes has been a hotly debated topic in United States politics. With the passing of the Affordable Care Act (ACA) there is now a sense that containing costs maybe on the horizon. This paper will focus on the Triple Aim model to improving health outcomes. It will breakdown implementation of Triple Aim, define the key element population health, and provide an example of a Triple Aim success story.

Increasing healthcare costs without a corresponding increase in health outcomes is something the United States has been dealing with for years. In fact, it is estimated that thousands of individuals die every year due to errors (To Err is Human, 2000). Finding a way to reign in those costs and increase health outcomes has been a hotly debated topic in United States politics. With the passing of the Affordable Care Act (ACA) there is now a sense that containing costs maybe on the horizon. This paper will focus on the Triple Aim model for improving health outcomes. It will breakdown implementation of Triple Aim, define the key element population health, and provide an example of a Triple Aim success story.

A comprehensive review of our nation’s overall healthcare costs disclose that only 1% of the United States population is consuming 20% of the total costs, while 10% of the

Since 1984, Medicare patients have been serviced under the prospective payment system of the Medicare program. Under this system, primary care providers are reimbursed for their services using a fixed payment for each patient that is determined by the patient’s diagnosis-related group at the time of the admission. Therefore, under the prospective payment system a hospital’s reimbursement is unaffected by the actual expenditures that are required to care for a patient.

According to the Garber & Skinner (2008), the United States spends more on health care than other nations but continues to score below other nations in numerous areas of measurement. These scores in, consideration with amount spent, suggest that healthcare is the United States is inefficient. Additionally, the United States has a significantly large portion of under

This article reviews the history of Medicare’s Hospital Readmission Reduction Program (HRRP) which began in October 2012. It examines why Medicare and Medicaid initiated the program, clarifies what conditions were originally included in HRRP and analyzes the reasoning behind adding Chronic Obstructive Pulmonary Disease (COPD) to the list of high priority conditions. It also, clarifies what information U.S Centers for Medicare and Medicaid (CMS) take into consideration when calculating readmission rates and points to the fact that high readmission rates could be due to non-hospital factors. The authors review new data that focuses on the potential harm of adding COPD to the list of conditions due to the increased level of patients from lower

The single most important impetus for healthcare reform throughout recent history has been rising costs (Sultz, 2006). In the book called The healing of America: a global quest for better, cheaper, and fairer health care, Reid wrote that the nation’s health care system has become excessively expensive, ineffective, and unjust. Among the world’s developed nations, the US ranks near the bottom for healthcare access and quality. However, the US ranks at the top for health expenditure as a percentage of the Gross Domestic Product (GDP) and average of $7,400 per person (Reid, 2010). Therefore, Americans are spending

Value-based purchasing (VBP) outlined by Roussel et al. (2016) is a payment methodology that rewards quality of care through payment incentives and transparency. Some of the key elements comprise of:

Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster

This memorandum describes Central Health’s Readmission Reduction Program set to commence in May 2017. The Centers for Medicare and Medicaid Services (CMS) has raised concern over the increasing readmission rate and poor quality of care. To address this issue, Congress has created Hospital Readmission Reduction Program (HRRP) statute under the Affordable Care Act, 2010, which was recently updated under 21st Century Cures Act of 2016. Under the constant pressure of a penalty, Central Health has considered to establish its own Hospital Readmission Reduction Program to address specific imperatives, such as care-coordination, treatment adherence program, and streamlined patient discharge process.

The Affordable Care Act has enable Medicare & Medicaid Services(CMS) to link Medicare’s payment system to a value-based purchasing system to improve healthcare quality1. Hospital Value-Based Purchasing (VBP) which is part of the Centers for Medicare & Medicaid Services; the program allows

As noted early the triple aim was implemented by the Institute for health care improvement (IHI) in 2007, to help with increasing the patient experience, reducing the cost for health care and increasing the quality of care for the patients. The reason why it is so difficult to implement because the health care organizations have to put money upfront for the program and it takes a while for organization to recoup the money that they invested in the program. When the organizations focus on the population health they can identify the three issue with the triple aim and make improvements within that population. The way that hospital staffs interpret triple aim is based on two models which is the professional ethos and the socio-political

Steven Brill feels that American health care is eating away at our economy and our treasury and discusses the costs associated with the provision of health care services in the U.S.. The article explores the medical world through the medical expenses incurred by a 64-year-old Janice S., Sean Recchi, A 42-year-old from Lancaster, Ohio and several other egregiously billed patients. The article poses the question: why exactly are the medical bills so high; in particular hospital bills?

Nurses are the first ones to recognize the changes and challenges caused by transition in patients’ lives. Moreover, nurses often prepare or facilitate their patients to face these transitions