With rare exceptions, US health care as a system is disjointed, inefficient, and ineffective in promoting population health and in providing full value for the resources invested. This occurs despite the good intentions of clinicians, health care administrators, and other participants in the system. Other developed nations receive far better value for the resources invested as evidenced by better population health outcomes, and lower per capita cost of care. However, even in countries with highly integrated systems for delivering health care, there are still significant opportunities for improvement.
IHI’s innovation team developed a concept design and described an initial set of components of a system that would fulfill the Triple Aim. The five components are listed below, and a more detailed list can be found in the Concept Design document (see below).
- Focus on individuals and families
- Redesign of primary care services and structures
- Population health management
- Cost control platform
- System integration and execution
The Triple Aim concept also includes roles for “macro” and “micro” integrators. The macro-integrator is not necessarily a new structure or organization, but rather an entity that can pull together the resources to support a defined population, and make sure that the system is optimized for the sake of the defined population. The macro-integrator works with and helps to improve the front-line systems that support individuals. The micro-integrator is the person or team that makes sure that the best and most appropriate care is provided to individuals. In effect many individuals act as their own micro-integrators. A primary care team or “medical home” could fulfill this role as well, and there are likely to be other workable approaches to micro-integration.
See the Summaries of Success on the Progress tab, describing the achievements to date of participating Triple Aim sites.
