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What is the 'Triple Aim' of healthcare?

Healthcare professionals use the Triple Aim framework

This article has been vetted by University of Phoenix's editorial advisory committee. 
Read more about our editorial process.

This article was reviewed by Mark Jóhannsson, DHSc, MPH, Dean, College of Health Professions

At a glance

The Triple Aim philosophy is a framework designed in 2007 by the Institute for Healthcare Improvement (IHI). As the name suggests, the framework consists of three main components, which together are designed to optimize the performance of the healthcare system.

These components are population health, patient experience and per capita cost of health care.

  1. Population health focuses on the health needs of the wider community. By homing in on steps like preventive medicine and education, the population can decrease its reliance on the healthcare system.
  2. Patient experience focuses on the level of service the patient receives when they do require health care.
  3. Cost per capita seeks to reduce the overall per capita cost of health care. The United States spends more on medical care per person than anywhere else in the world, and cost affects access and quality of care in many communities. 

Here’s a closer look at how the Triple Aim philosophy seeks to improve the healthcare system in the United States. 

The Triple Aim framework

Ultimately, the goal is to improve the overall health of the population while reducing the costs of medical care. The Triple Aim framework is not necessarily three different goals. Instead, the components should be seen as three steps to approach simultaneously to achieve the same goal. 

In a country with an extraordinarily expensive healthcare system, that might sound unachievable. Triple Aim seeks to address this challenge by breaking down improvements into small, doable steps that are easy to measure. 

Improving the patient experience

The first facet of Triple Aim is to improve all aspects of the patient experience. In addition to emphasizing that organizations have the right skills to bring about positive outcomes, this step calls for systems to be in place that evaluate the experience and implement changes for improvement. 

Sometimes these improvements involve making the healthcare system, which many people have trouble navigating, more user-friendly. Initiatives may include care coordination and communication with patients.

Improvements also focus on compliance with healthcare regulations regarding privacy as medical facilities embrace the convenience of current technology. 

Reducing costs

As the population ages and the number of people in need of regular health care increases, reducing costs becomes increasingly important. Among the 11 high-income countries evaluated as part of a Commonwealth Fund analysis of Organisation for Economic Cooperation and Development health data, the United States spent more on health care but continued to face significant challenges, such as the lowest life expectancy and the highest suicide rate.

Cost reduction in Triple Aim has two components. The first involves finding ways to decrease the costs of care in medical facilities, of medications and of treatments. 

The second cost-reduction factor is to focus on prevention. By focusing on giving people the necessary resources for good health, Triple Aim works to mitigate the need for health care as people age. 

Improving population health

Improving population health goes hand in hand with health care cost reduction and improving patient experience. The goal of this Triple Aim aspect involves understanding the public health needs of the population as well as the health challenges they face.

For example, social factors can affect health when it comes to mental health, communicable diseases and preventable conditions like diabetes. 

The population health component of Triple Aim calls for improved communication and outreach. It also involves researching the factors causing the illnesses and conditions within a given community. Using public health efforts to help prevent illnesses and conditions prevalent in a community can go a long way toward reducing health care costs and improving care for the people who do need medical assistance. 

Learn more about evidence-based practice in healthcare.

Challenges with Triple Aim

Triple Aim has achievable and logical goals that can reduce costs and improve experience and outcomes. However, the challenges associated with implementing Triple Aim have slowed down its popularity

Here’s a look at some of the most common pitfalls healthcare organizations encounter: 

  • Implementing Triple Aim may increase medical staff burnout. Medical staff burnout is a common issue in the U.S. healthcare system, and some worry Triple Aim would exacerbate it. Today, burnout is caused by understaffing at medical facilities, unrealistic expectations from administrators and, most recently, the COVID-19 pandemic. In addition to a lack of energy and an increased frequency of mistakes, physician and nursing staff members who experience burnout may develop health problems. 
  • Triple Aim doesn’t do enough to address disparities within the healthcare system. Wealthier patients or individuals with comprehensive insurance may receive better care and referrals to specialists without hesitation. Meanwhile, patients with little to no insurance coverage sometimes avoid essential medical care due to the expense
  • Politics and health care don’t always mix. Some politicians focus on issues such as high prices for medication or insurance premiums during election season, but once in office, they fail to bring lasting changes that solve these issues. 
  • Misperceptions about Triple Aim can drive dissatisfaction. Some healthcare workers perceive Triple Aim’s goals as solely focused on patients and the public. A new philosophy, like that of the so-called Quadruple Aim, includes more support for workers. 

Of course, some of these drawbacks are a mixture of actual challenges and misperceptions. Luckily, certain benefits of Triple Aim directly address some of these challenges with solutions. 

Benefits of Triple Aim

The Triple Aim philosophy strives to improve the healthcare system by making it easier to navigate and more effective. Here are some additional potential benefits of this public health philosophy. 

  • Triple Aim streamlines care. Because the system focuses on prevention, community members can get most of their medical needs met through their primary care provider. With one primary contact, it is easier for people to navigate the healthcare system. 
  • Triple Aim leads to an understanding of a community's specific health care needs. Triple Aim helps medical organizations identify problems in the community before they escalate into health concerns. 
  • Medical providers can understand how to best serve the community. When the public can receive necessary preventive care, it decreases the workload for service providers: People with chronic illnesses can better manage them and diminish their need for more invasive or emergency care.
  • The community-based approach allows healthcare organizations to work with community institutions, such as local businesses, schools and places of worship, to address health care issues that affect the community. This type of outreach can lower the overall cost of health care and involve other trusted institutions in the process.

The Triple Aim philosophy is most effective when implemented correctly in a community.

Implementing Triple Aim

Triple Aim requires that all three principles be incorporated in medical organizations' daily work and operational policies. The effort can start even before healthcare providers see their first patient. 

By ingraining the Triple Aim approach in healthcare degree programs, clinicians, technicians and administrators will already have an understanding of the benefits and public-health-centered approach of Triple Aim when they begin their professional duties. 

Providers need to understand how the patient-centered philosophy can make their lives easier too. Most of all, hospital and clinic leadership needs to embrace public-focused health care for it to become effective in a community. Making Triple Aim part of health administration degree programs can help decision-makers understand its benefits. 

This implementation also requires that healthcare organizations attract skilled nurses, doctors and administrators to facilities that incorporate this health care approach. It may also require a more diverse nursing workforce with providers who can perform their jobs in nontraditional settings and can reach out to underserved members of the community. 

Integrated effectively, Triple Aim has the power to transform healthcare, one facility at a time.