This paper analyzes the Triple Aim Initiative as a framework for reforming the United States healthcare system. It examines the initiative's three core objectives — improving population health, enhancing care quality, and reducing costs — alongside the structural requirements needed for successful implementation. The paper identifies key barriers to reform, including supply-driven care models and physician-centric resistance, and discusses how electronic medical records (EMRs), exemplified by Kaiser's adoption, can support the initiative's goals. A brief comparative look at the United Kingdom's Beveridge Model highlights how other industrialized nations have achieved broader healthcare coverage at lower individual cost.
The United States has one of the most flawed healthcare systems in the industrialized world. Thousands of Americans do not have any healthcare coverage, and costs associated with haphazard care are skyrocketing. Recently, there have been a number of reform efforts to help improve the situation for everyday Americans. The Triple Aim Initiative is an attempt at accomplishing three major objectives: improving health in the United States, enhancing the quality of available healthcare, and reducing the overall costs associated with healthcare.
There are a number of issues that must be addressed for the Triple Aim Initiative to succeed. A massive overhaul of the current state of healthcare in this country is needed to facilitate its goals. As one source suggests, "for the Triple Aim Initiative to be utilized, it needs a population or group that can be tracked over time, policy constraints that shape the balance of how much to spend on healthcare and whom that coverage will include, and an integrator or someone to accept responsibility for its three goals" (O'Toole, 2009, p. 47). The successes or failures of the reform must be observable as a way to help guide future healthcare policy. Additionally, healthcare practitioners must look for methods of reducing costs without sacrificing the quality of care they provide to their patients.
One method for increasing the quality of care is giving physicians easier access to medical records on shorter notice. The article discusses how electronic medical records (EMRs) are more effective in providing physicians the necessary tools, especially when compared to failing HMO organizations. One success story of EMR adoption is the Kaiser organization. In just a few years, Kaiser dramatically improved its services, increasing the quality of care while reducing costs — partly thanks to sophisticated EMR strategies that replaced outdated and slow record-keeping systems. Such legacy systems only bog down healthcare delivery and end up burdening consumers. Kaiser has managed to refine its internal communications and record-keeping to provide high-quality care across all service types under one roof.
There are a number of clear barriers to the Triple Aim Initiative. One such barrier is the pattern of supply-driven care, which has proven extremely costly to the average consumer and patient. This model of healthcare has created a multi-billion dollar industry in which patients' needs are sidelined so that healthcare organizations can maximize profit margins through a system that resembles a production line more than a hospital facility. Unfortunately, as O'Toole (2009) notes, "producers control demand" (p. 48). With so many major companies profiting from this style of healthcare, they will undoubtedly resist reform initiatives like the Triple Aim, which aims to rework the system in order to relieve consumers of financial burden without reducing the quality of care they receive.
Moreover, the physician-centric model that dominates much of today's healthcare also poses a barrier to the Triple Aim Initiative. Under this model, physicians resist reform measures that would reduce costs because such reforms would effectively reduce their own earnings. As a result, many physicians actively oppose reform efforts and do not implement potentially beneficial changes within their own facilities. Even when reform is imposed on them, the quality of care often declines alongside the associated costs. These entrenched interests — both corporate and professional — represent significant structural obstacles to achieving the Triple Aim's goals.
"UK Beveridge Model contrasted with U.S. system"
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