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Cms triple aim12/30/2023 Three years into the collaborative, we examine change in triple aim measures and identify factors associated with improvement. 9 Given the success of these initial two collaborative cohorts, we focused a third phase of the I3 collaborative (I3 POP) on improving care of populations served by primary care teaching practices in North Carolina, South Carolina, and Virginia in three broad areas (the triple aim): care quality, appropriate utilization, and experience of care. In 2005, the I3 Collaborative was chartered to address ways to improve chronic disease care in family medicine residencies 5 and subsequently expanded to address patient-centered medical home recognition in family medicine, internal medicine, and pediatrics teaching practices. 6,7 Nonetheless, the powerful forces of declining reimbursement rates, emergence of narrow networks in health exchanges, and enhanced focus on medical costs and reputation require greater transparency and accountability for cost, satisfaction, and health outcomes. ![]() The necessary process of measuring and improving quality in academic medical center environments, however, can prove challenging given academia’s tripartite mission of research, teaching, and patient care. With the changing landscape of primary care delivery, knowledge, and skills in assessing and impacting population health management, improving processes of care in practice settings and managing change are critical for physicians. In response to this, faculty development initiatives are examining the transformation of primary care residency training and the clinical practice setting. These models currently target practicing clinicians however, it is necessary to train future primary care physicians so that they are prepared to meet triple aim goals in their future practices. 2,3 These programs specifically include quality, cost, and patient experience and are directly impacted by primary care. 1 Several value-based payment models are underway, including the development of Next Generation Accountable Care Organizations (ACOs), alternative payment models and merit-based incentive programs (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA). Future work needs to focus on cultivating leadership and systems supporting large scale improvement.Īccording to leading health care experts, the US health care system needs to address the triple aim of improving the patient experience of care, the health of populations, and reducing unnecessary costs. I3 POP practices that were able to pull and report data improved on at least one measure. Practice interviews revealed that engaged leadership and systems supports were more common in higher performing practices.Ĭonclusions: Simultaneous attainment of improvement in all three triple aim goals by teaching practices is difficult. Practices with a greater number of patient visits were more likely to show improved measures (odds ratio 10.8, 95% confidence interval. All of the remaining 23 practices reported improvement in at least one measure, with 11 seeing at least 10% improvement seven (24%) improved measures in all three triple aim areas, with two experiencing at least 10% improvement. Results: Six of 29 practices (21%) were unable to extract measures from their electronic health records (EHR). Participant interviews explored supports and barriers to improvement. Outcome measures included quality (chronic illness, prevention) utilization (hospitalization, emergency department visits, referrals) and patient experience (access, continuity). ![]() The Institute for Health Care Improvement Breakthrough Series Collaborative model was tailored to focus on at least one triple aim goal and programs submitted data annually on all collaborative measures. ![]() Methods: Twenty-nine teaching practices representing 23 residency programs participated. We examined change in triple aim measures over 3 years, and identified correlates of improvement. Background and Objectives: The I3 POP Collaborative sought to improve health of patients attending North Carolina, South Carolina, and Virginia primary care teaching practices using the triple aim framework of better quality, appropriate utilization, and enhanced patient experience.
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