Employer-Initiated Improvement

With the rising costs of health care, both employers and employees have a vested interest in minimizing the costs of care, as much as possible, while still retaining access to high-quality care. Employers are in a unique position as purchasers of health care services for their employees to improve health, enhance the experience of care, and manage per capita cost — the IHI Triple Aim.

The traditional approach to purchasing health care has been isolated and transactional — employers and health plans negotiate, health plans and providers negotiate, and employees receive limited options for health care access. This approach focuses on sector-specific tactics and presents zero-sum gains and losses for the health care system.

A better approach exists.

Using System Design to Improve Health and Control Costs

By focusing on a system-wide initiative aimed at redefining the expectations of each sector, without over-relying on any one relationship, the sectors can work together towards Triple Aim goals. We are altering the dynamic of competing interests to identify and capture cost reduction opportunities, simultaneously bringing together and building capacity among employers, workers, unions, health plans, and health care providers.

IHI has developed a framework to bring the various stakeholders in the health care purchasing arrangement together in order to achieve Triple Aim goals through system-level co-design. IHI’s ability to convene various partners enables employers, providers, and health plans to establish common goals, build trust, develop new business models, and define the respective roles of competitions and cooperation. With successful tests of change, regional goals can be met to improve health, enhance the experience of care, and manage per capita costs.