Exploring the Iron Triangle in Healthcare Systems

Abstract:
The Iron Triangle is a device used to evaluate all kinds of health care systems. The Iron Triangle concept originated with William Kissick MD, a professor of medicine from University of Pennsylvania, who worked on the original Medicare proposal. Those who devised the recent reform measures passed by Congress in 2010 employed this concept. The three parts of the triangle are quality, access and cost. Quality is the value of service, competency, efficacy, reliability, and outcome of the care being delivered to patients. Access is who can get the care when it is needed, not how long it took to get the required care. Cost is when various systems need to make costs more affordable for patients and those who pay, whether that is the U.S.

The Affordable Care Act of 2010 established the Hospital VBP Program. The Hospital Value-Based Purchasing (VBP) Program is a Centers for Medicare & Medicaid Services (CMS) initiative that rewards acute-care hospitals with incentive payments for the quality of care they provide to Medicare beneficiaries. A few of the value based purchasing provisions such as pay for performance, accountable care organizations, bundle payments and patient-centered medical homes are designed to improve care quality and outcomes while reducing the cost (cms.gov). Within the iron triangle, the goal of VBP is to improve quality and cost, but it should also help towards providing more access to care. If patients are not able to access the care when they need it then quality is insignificant. One key component of VBP is measuring and reporting comparative performance of providers - allowing patients to select services and providers of high value. Based on provider’s performances, VBP programs pay each differentially, which encourages providers to emphasis more on outcome and care rather than capacity of work. And so, providers cut out unnecessary work and used their resources more efficiently to lower their overall care costs. VBP programs can also inspire providers to advance their work efficiency by implementing and integrating technology into their care. With assistance of the right technology providers can implement telehealth to save time and cost in order to be able to focus on more patients. Access to most patients is possible as long as costs of care are affordable. By adopting VBP programs, they will be able to keep the cost affordable by implementing cost cutting strategies without compromising quality care for