Reminding us why the Triple Aim has three parts
Since Donald Berwick’s powerful 2008 Health Affairs article the phrase ‘Triple Aim’ (i.e., improving the experience of care, improving health, and reducing costs) has been so widely used that we risk losing its meaning.
Recent events in other industries are a reminder of why balancing multiple objectives is so important (and why the Triple Aim has three parts):
- Over-emphasize cross-selling: Wells Fargo signing customers up for products they didn’t ‘buy’
- Over-emphasize becoming the largest automaker: VW emissions deception
- Over-emphasize near-term revenue: Epi-Pen price increases
Leading an organization is about balancing multiples goals. It’s simpler to have one objective, but in most situations (and in most of life) it doesn’t work out as well as intended.
Chief Administrative Officer and Co-Founder MIND 24-7
8 年Larry, this is a great commentary, and certainly timely.
Director of Wealth Management Strategy at UBS
8 年Larry, I hope all is well. I think that you are quite right that in an ideal world, there would be only one metric to chase, but in the real world, multiple forces often take hold. That is why, of course, they pay the CEO the big bucks in order to balance those issues effectively, and to do so in a way that certainly does not cross the rubicon of illegality, but also maintains a proper level of ethics. That's why it is the CEO role to set the tone, and build a culture that respects both business targets and integrity. Of course, that also means, to quote a Reagan aphorism from the 1980s, the business must "trust but verify." Ideally, workers will act properly out of respect for clients, vendors and co-workers, but in the real world, there should be processes in place to catch misbehavior. So long as those processes (and people who manage them) are independent of the forces that could cause the misbehavior in the first place, the system will stay mostly balanced. Now, not that I want to disagree with an old teacher, but I'm not sure that I agree with you on the Epi-Pen point. In fact, in the face of near-monopoly power, it is not at all unreasonable to believe that the price of such an item would go up, perhaps precipitously so given the nature of demand. Mylan's problem was not that they raised prices, but rather it was that they did so in a way that invited criticism. Given the lack of another viable substitute, they probably should have raised prices gradually in order to stay under the public's radar. I don't see that as a multiple goal satisficing issues, but rather a blunder in strategic pricing execution.