As health care providers within a CIN begin to think collectively, with a shared focus on the health needs of a particular patient population, they will inevitably need to consider and plan for referring patients to other providers within the CIN who understand the value-based goals of the CIN and the most efficacious treatment of the patient. CINs need to develop structures and tools to do this.Īs health care providers consider integration in a CIN, they must, first and foremost, undertake careful and attentive planning to ensure compliance with the health care regulations pertaining to referrals among health care providers. CINs must ensure that the most up-to-date data on each patient is immediately accessible for delivery of patient care and must utilize their clinical data to better understand and respond to the target population's health outcomes and needs. Thus, CINs must remain acutely aware of, flexible with, and responsive to patient population needs. Health care, however, is anything but stagnant. To do this well, a CIN must understand its target patient population's needs, analyze data to determine proper clinical responses to those needs, and monitor its providers' delivery of those clinical measures. To achieve the Triple Aim, a CIN must strategically identify and organize around patient care goals and develop delivery models that achieve those goals at a lower cost. The main takeaway here is that success takes time and dedication to collaborate from the top down. See Pursuing the Triple Aim: The First 7 Years, The Milbank Quarterly, June 2015, 93(2): 263-300. Establishing a learning system to drive and sustain the work over time, which most often includes (perhaps, even requires) strong and secure data sharing among providers to allow them to track patient choices and impact on their health.Ensuring scalability as the CIN forms, develops, and grows, as the expertise of the providers in the CIN must accommodate the particular needs of the patient population.This includes a strong governance structure and a sense of purpose. Creating a foundation for population management of an identified population.In a 2015 study published by IHI, CINs have shown they are successfully structured to meet the Triple Aim when they achieve a few markers. The point is for the CIN to identify the specific health care needs of a population, and the attendant costs in addressing those needs, and to organize in a meaningful and purposeful way to address the same to aim for quality outcomes for the individual patient and the population as a whole. For example, a CIN may negotiate with a payor to manage the health care of an identified population and receive upside and downside financial risk associated with the same it may contract to care for one or more employers' self-insured employee populations or it may identify a community need to address a particular underserved patient population. The patient population a CIN manages may take various forms. (2) Reducing the per capita cost of health care. (1) Improving the patient experience of care.

According to the IHI, in order to provide the highest quality of care, health care systems and providers should focus on: national strategy for health care, making it incredibly salient for all American health care organizations. The Triple Aim was developed by the Institute for Healthcare Improvement (IHI) in 2007 in order to establish priorities for a modern health care system.

Triple aim of healthcare reform