Triple Aim Overview
According to the Institute for Healthcare Improvement (IHI),
“The US health care system is the most costly in the world, accounting for 17% of the gross domestic product with estimates that percentage will grow to nearly 20% by 2020. [Source: National Healthcare Expenditure Projections, 2010-2020. Centers for Medicare and Medicaid Services, Office of the Actuary.] At the same time, countries with health systems that out-perform the US are also under pressure to derive greater value for the resources devoted to their health care systems. Aging populations and increased longevity, coupled with chronic health problems, have become a global challenge, putting new demands on medical and social services.”
The IHI seeks to improve healthcare in the U.S. by focusing on these three elements which they refer to as the Triple Aim:
- Improve the quality and satisfaction of patient experience of care
- Improve the overall health of the population
- Reduce the per capita cost of healthcare
At present, no one is accountable for all levels of the foregoing elements in most medical centers. IHI’s concept design believes the following five elements would satisfy all three aspects of Triple Aim:
- Focus on individuals and families
- Redesign of primary care services and structures
- Population health management
- Cost control platform
- System integration and execution
More on the inner workings of Triple Aim can be found here.
Essential Health Benefits (EHB) of ACA
According to the Center for Medicare & Medicaid Services here, the Affordable Care Act (ACA) requires non-grandfathered individual and small group insurance plans to cover essential health benefits which include items and services in ten benefit categories:
“Beginning in 2014, the Affordable Care Act requires non-grand fathered health plans to cover essential health benefits (EHB), which include items and services in the following ten benefit categories: (1) ambulatory patient services; (2) emergency services;(3) hospitalization; (4) maternity and newborn care;(5) mental health and substance use disorder services including behavioral health treatment; (6) prescription drugs; (7) rehabilitative and habilitative services and devices;(8) laboratory services;(9) preventive and wellness services and chronic disease management; and (10) pediatric services, including oral and vision care. The essential health benefits should be equal in scope to a typical employer health plan.”
How this affects New Hampshire insurance plan requirements is outlined in this pdf file from the Center for Medicare & Medicaid Services. However, each state also defines and adopts additional benefits according to their own legislative appointees in instituting the various portions of the Act. Triple Aim has looked at the ACA’s Essential Health Benefits as incorporating much its own intent incorporated into the ACA.
Of course, the ACA itself is a matter of much controversy these days. It is not the intent of this page to attempt to sway any reader in regards to the ACA. It is, rather, to bring to the attention to the reader how massage therapy fits into Triple Aim and the Essential Health Benefits portion of patient care.
Massage and Healthcare
Manchester-Bedford Myoskeletal LLC believes in an integrative approach to patient healthcare. The musculoskeletal system is proving to be a growing concern to mainstream medicine and New Hampshire Licensed Massage Therapists can be valuable resource for improving the health of patients in a range of medical conditions and pathologies.
Our original schooling requires basic learning and understanding of anatomy and physiology, the musculoskeletal system and pathologies, patient interviewing and some assessment, kinesiology, massage theory, techniques, benefits, and contraindications, hydrotherapy, joint movement, communicable disease control, and introduction to Traditional Chinese Medicine, among other important conventional aspects of patient care, such as ethics, business management, hygiene and sanitary practices. Beyond original schooling, NH LMTs must earn approved continuing education credits each two-year license renewal period in direct or allied bodyworker subjects.
New Hampshire rules governing Licensed Massage Therapists can be found here.
Many LMTs, including the manager of this practice, have chosen to pursue more clinically relevant, medicially oriented advanced trainings in anatomy, physiology, neurology, functional movement, kinesiology, structural aspects of the body, pathology, etc. However, all LMTs have the basic qualifications to work in some aspects of the ten Essential Health Benefits.
The American Massage Therapy Association* developed a paper on the subject, which we have linked to here. Included in the paper is how they view massage fulfilling aspects of Triple Aim and the EHB as an integral part of healthcare. While the research on Western massage therapy still needs significantly further study, there seems to be plenty of agreement that massage displays efficiacy in EHB points 1, 5, 7, and 9.