Discussion
Establishing A Feedback Loop A feedback loop is necessary for assessing the impact of the preventive program on outcomes. This step may be valuable both for evaluating the program and for refining the impact ability model. For example, a regression analysis might show that patients with certain characteristics were more likely than others to respond to an intervention. This knowledge could then be used to adjust the impact ability model to ensure that patients with these characteristics were prioritized in the future, unless that adjustment violated ethical considerations.
Current Policy Context the Triple Aim is becoming increasingly important to policy makers in developed countries as their populations age, chronic diseases increase in prevalence, and funding constraints become pressing. Predictive modeling is now widely accepted in the United States, but the use of impact ability models is less extensive.
New financial and quality rules are giving hospitals and accountable care organizations incentives to prevent Triple Fail events such as avoidable readmissions. However, many such organizations are relying on population strategies to achieve these goals, including better care coordination and improvements in information technology. Ultimately, success will probably require targeting specific subpopulations as well.
Recommendations The following recommendations could promote the appropriate use of the stratified approach to the Triple Aim.