Sometimes I’m amazed by the evolution of the improvement movement in health care. Recently, I was at the annual Premier Governance Education conference. For years, these meetings focused on quality, safety, new care delivery designs, and stronger staff engagement and teamwork. All of these are still central elements of improvement of course, and all are discussed at these conferences.
But what struck me at this latest Premier meeting (and other meetings recently) was how the conversation has changed. It’s evolved into a broader discussion that includes the entire continuum of care. The conversations these days seem to always lead to the Triple Aim ---- simultaneously improving the health of the population, enhancing the patient experience of care (including quality, access, and reliability), and reducing the per capita costs of care. At so many of the places I visit, I see inspiring progress on both the health of the population and on the patient experience of care.
As we all know, however, the big barrier is cost. I hear this everywhere I go, and I see organizations everywhere working on the issue. Many of these organizations have turned to IHI for help so we’ve been thinking about how to simultaneously engage employers, health plans, and health care providers to work together to improve employee health and lower insurance premium costs.
This past fall, we began collaborating with employers in a new program called Healthy Employees, Lower Premiums & Costs. The program aims to combine individual, sector-focused approaches into a coherent system with the aim of lowering costs to employers and their employees while improving employees’ health and their experience within the health care system ---- in other words, IHI’s Triple Aim.*
One of the reasons I’m so excited about this new program is that we’re engaged in this work as an employer as well as a convener! Like any employer, IHI has a keen interest in having the healthiest possible workforce and in controlling the costs of our health care needs and health plan premiums. We kicked the year off by inviting IHI employees to fill out a Health Risk Assessment (HRA) that can be used to identify key areas for each employee to focus on to improve their health. (I am happy to say I was the first person in line to take the HRA). Learning more about how to improve our own health is crucial, but the HRAs also allow us to learn a great deal more about the health needs of our population. This will give us better insight into our past costs, enabling us to work with our insurer to better design benefits that will drive us toward the Triple Aim.
The motivation of employers throughout the United States ---- from small companies to global corporations ---- to control costs while improving the health of their employees has never been greater. It is one of the truly burning issues in the business world.
The Healthy Employees, Lower Premiums & Costs work is structured to achieve significant, rapid results by engaging various shaped alliances that work closely together. These alliances could take the form of a large, self-insured employer partnering with two major health care providers in their region and their third-party administrator; or ten small to medium companies with the same health plan vendor, joining together to increase their influence with local health care providers. Regardless of the form they take, the commitment of each alliance is to reduce overall costs.*
As with all improvement work, genuine learning depends on shared, transparent data. Participants in the initiative have agreed to share data, both on costs, and on outcomes. The outcomes we’ll be looking at come straight from the Triple Aim ---- we’ll be measuring cost, patient experience, and population health. And we’ll make the data reporting and sharing as easy as possible.
I know so many of you are thinking about these issues right now. The sustainability of our businesses and health systems, and the health of our workforces, depend on significant improvement. I know we can do it together.
*excerpted from Healthy Employees, Lower Premiums & Costs: How to Get the Health You Pay For (Prospectus, Jan. 2013)