Triple Aim alone will never bend the cost curve, experts say

Pop Health Forum speakers said that the Triple Aim needs to be expanded to include improving the physician experience and educating consumers or the concept will never markedly reduce costs.

By Tom Sullivan

September 13, 2016

10:11 AM

CHICAGO — Population health consultant Steven Nathasingh predicted that without alterations to its core philosophy, the Triple Aim’s goal of better patient care that leads to healthier populations while reducing costs would never be accomplished.

“I can assure you that in 50 years time, where we want to end up bending the cost curve, we won’t bend that curve,” Nathasingh said here at the Pop Health Forum 2016.

The missing piece, Nathasingh added, is influencing patients to take more control over their own health.

“When you look at the Triple Aim’s three components, there’s a big disconnect between what it’s trying to achieve and what the end-goal should be,” Nathasingh said. “The system is focusing on itself – it should not be solely about itself. We’re trying to improve the system without educating patients and their families.”

Whereas Nathasingh is perhaps bringing patient accountability as a new idea relative to the Triple Aim, there has been some hue and cry about incorporating the physician experience to transform The Triple Aim into the Quadruple Aim.

John Muir Health, in fact, is among the hospitals already evoking the Quadruple Aim, according to Christy Kaplan, Vice President of Care Coordination and Integration at John Muir.

In John Muir’s case, for instance, Kaplan explained that the system is integrating evidence-based medicine, building a longitudinal health record, communicating with payers as well as making inpatient and ambulatory EHRs interoperable. The aim of all that work is equipping clinicians with tools and data to more effectively treat patients, rather than essentially forcing them to wrangle with technology.

“The Quadruple Aim means getting our nurses and care managers to shift their thinking away from what they’ve been doing for years to the new paradigm of total cost of care, including the clinician experience,” Kaplan said.

Whether the Triple Aim formally evolves into the Quadruple or Quintuple Aim — and if any of those iterations will succeed and survive 50 years into the future — is now and will continue to be very hard to predict. But it’s safe to say that calls to expand the Triple Aim will only grow louder.

“Triple Aim, Triple Aim, Triple Aim. We beat that term to death,” said Shelley Price, HIMSS Director of Payer and Life Sciences. “But it’s still critical.”

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