Diverse field is united in pursuing the Triple Aim, says AHA chairman
The hospital field is broad and diverse, and each organization may bring its own solutions to the challenges presented in its community, says AHA Chairman Jonathan Perlin, M.D. But he says the field shares a unifying goal – pursuit of the Triple Aim in health care.
“It’s an important year for the AHA in understanding how we can best support our members’ commitment to the Triple Aim,” says Perlin, who is the Nashville, Tenn.-based Hospital Corporation of America’s (HCA) chief medical officer and president of its clinical services group.
The Triple Aim is a framework developed by the Institute for Healthcare Improvement that calls for simultaneously improving population health, care that’s provided and value. Perlin says it holds great promise for the future of American health care.
“By embracing the Triple Aim, hospitals are tangibly supporting the AHA vision for a society of healthy communities, where all individuals reach their highest potential for health,” says Perlin, who became AHA chairman on Jan. 1. “That is a tremendously exciting and admittedly complex opportunity and challenge.”
There are already signs of solid progress. For example, the Centers for Medicare & Medicaid Services recently reported that the growth in health care spending continued to slow, to a 53-year low, in 2013. A key driver of this trend is the slow growth in hospital prices, which increased by only 2.2% in 2013.
Also down is preventable harm to hospital patients; hospital-acquired conditions declined 17% between 2010 and 2013. That translates into an estimated savings of some 50,000 lives and $12 billion in health care costs.
“The AHA’s work with hospitals and health systems is not only bending the cost curve, but the quality and safety curves, too,” Perlin observes.
The AHA chairman sees the association stepping up its efforts to help members reinvent health care and lay the groundwork for a true system of care that will ensure a healthier America for generations to come.
As an example, Perlin cites the work of the AHA’s Committee on Research, which he led last year as the AHA’s chairman-elect. Each year, the committee examines in-depth one of the most pressing health care challenges. The 2014 research produced a report, “Redefining the H,” which is scheduled to be released next week.
In the coming years, the image of a hospital will be less about four walls and more about partnerships that advance the health of individuals and communities. Perlin says the new report is intended to support hospital and system leaders in engaging effectively with their community leaders and service organizations about how they work together in support of meeting care needs and improving community health. He also notes the critical role of hospital board members in facilitating the dialog.
An AHA board member since 2011, Perlin served on the board’s executive committee and as its liaison to the AHA Physician Leadership Forum’s committee on clinical research.
He has been HCA’s chief medical officer and head of clinical services since 2006. With some 165 hospitals and 115 freestanding surgery centers, HCA describes itself as the nation's leading provider of health care services.
Before joining HCA, Perlin served as the Department of Veterans Affairs’ undersecretary for health and as CEO of the Veterans Health Care Administration, where he led the nation’s largest integrated health system.
As hospitals move closer to a more integrated, value-based world, Perlin worries that burdensome government policies may hinder the journey. “As we’re trying to reinvent ourselves and support the Triple Aim, we’re also contending with a number of things that we know don’t improve value, don’t improve health and don’t improve care,” he says. “For example, regulatory processes need to be simplified so that provider resources are directed at care and health, not paperwork. The AHA has had a very clear voice on these issues, such as the burdens of the [Medicare recovery audit contractor] process.”
He notes that the “AHA’s advocacy voice is only as strong as the collective voice of its members. While there are many issues that might pull us apart, our strength in advocacy is in finding consensus on issues and common efforts in support of our shared mission to improve health and care.”
But he also says hospitals need to channel their aspirations for quality and performance improvement into constructive policy recommendations for legislators and policymakers. “The most constructive role we can play is to give legislators and policymakers well thought out, well-articulated and highly detailed recommendations for payment and program structure that allow us to add value most effectively in providing care,” Perlin says.
Asked what he will enjoy most about being AHA chairman, Perlin says “it will give me great pleasure to help contribute to and amplify the terrific work of colleagues across the country who feel as I feel, which is that we are blessed by the opportunity to serve individuals in our communities through health care.”
Hear what the AHA chairman has to say about the association’s ability to bring together many diverse views and build consensus around a national agenda. Listen in here.