This story originally appeared in the 2012 IHI Annual Report.
Steve Galen, President and CEO of Primary Care Coalition (PCC) of Montgomery County, Maryland, has lots of experience setting up health care delivery systems and making them work. He is also very good at bringing people together to solve big problems.
In 2007, PCC was one of 15 organizations chosen to prototype IHI’s Triple Aim, which seeks to transform health systems by simultaneously pursuing three aims: enhancing the experience of individual patients, improving the health of a population, and reducing the cost of care.
“Collaboration was our mantra.”
That experience, Galen said, moved PCC toward a “grander vision.” PCC soon became an “integrator” — an organization that builds connections among health care, government, and social service organizations so they can improve health more efficiently. “Collaboration was our mantra,” he says.
First, PCC worked with local emergency departments to ensure that patients automatically receive a referral to a safety net clinic for primary care. They also persuaded specialty care providers to treat patients for free. Finally, they worked with local organizations to expand capacity for low-cost mammograms and established patient navigation services at clinics to make it easier for women to get mammograms.
“The Triple Aim provides us with a framework that we can share with other people — our county government understands the Triple Aim. The whole community is moving toward a population health focus.”
Galen says this work required a completely new way of thinking about health care. “The Triple Aim provides us with a framework that we can share with other people — our county government understands the Triple Aim. The whole community is moving toward a population health focus.”
With support from Montgomery County Executive and County Council, PCC is now working to apply the Triple Aim principles to all 120,000 of the county’s low-income, uninsured residents. PCC believes that by bringing together many agencies and data sources, the county can reduce per capita health care costs by 20 percent while improving the health of the population beyond expectations.
“Steve has a deep understanding of the operational role of an integrator,” says Tom Nolan, IHI Senior Fellow and a statistician at Associates in Process Improvement. This enables PCC to initiate more ambitious projects than any one organization could pursue on its own.
Galen says it’s exciting to help hospitals, county agencies, and community organizations work together. “Normally there are levels of competition among all these players, and we’ve figured out how to work with all of them. It’s what I call magic.”
The team at IHI that leads the Triple Aim work
(pictured, from left to right: Martha Rome, Kathryn Brooks, Ninon Lewis, Carol Beasley)