The Triple Aim

September 11, 2016

In my Health, Technology, and Engineering (HTE) class, we had another speaker, Dr. Brian Prestwich, come in and talk about the $3 trillion U.S. healthcare system.

When the pricing model for software changed from an upfront license fee to a pay-as-you-go subscription used for cloud-based services, it revolutionized the technology industry. Similarly, the healthcare pricing model is changing from volume-based care to value-based care and it is revolutionizing the healthcare industry.


This change has been pushed forward largely due to Obamacare, more accurately called the Affordable Care Act. It is a law that challenges healthcare providers (hospitals, physician clinics, etc) to focus on the value a patient is receiving. Prior to this, doctors would be paid per procedure – a fee for service. Now, doctors are paid for positive patient outcomes – a fee for value.

The framework that guides this transformation is the Triple Aim, defined by IHI. The 3 aspects of values-based outcomes are:

Improving the patient experience and quality of care (did patient actually get better and did they feel like they did?)

  1. Improving population health (how can we treat similar patients in the community and chronic conditions?)
  2. Minimizing cost (how cost-effective was the treatment/care?)

The actors involved are:

  1. Patients – those being treated, the customer
  2. Providers – hospitals, clinics, physicians who give services to patients and try to meet the Triple Aim
  3. Payers – insurance companies, HMOs, the government health exchanges, etc who reimburse, or pay, the providers for the treatments and now are moving to a fee for value payment system

Though it brings upheaval and controversy, healthcare reform is heading in the right direction. By focusing on a fee for value and evidence-based medicine that determines how effective treatments actually are, the U.S. healthcare system is on a path towards (hopefully) better healthcare.

Published on September 11th, 2016

Last updated on April 1st, 2021