Paul Harkaway: From Volume to Value With the “Triple Aim Plus One”

In December 2016, at the Greater Detroit Area Health Council (GDAHC) Regional Payment Reform Summit, Paul Harkaway spoke with NRHI regarding the status of payment reform and its effect on the health care industry.

When it comes to transitioning from volume to value, Harkaway emphasizes his ‘Triple Aim Plus One’ philosophy, which consists of: Better Health, Better Care and lower total cost of care. The ‘Plus One,’ Harkaway explains, involves the process of returning the joy of practicing medicine back to the healthcare providers.

“The first three in the Triple Aim are laudable goals and they could be the sole focus,” says Harkaway. “However, if we don’t somehow improve the experience that the providers are having as well then it is going to be very hard to achieve the top three.”

With the numerous barriers to payment reform, Harkaway believes that time is one of the biggest. “Everyone I know that works in the healthcare industry spends most of their day putting out fires,” he explains. “This type of work in redesigning a system at best gets placed on the corner of their desk until it is buried under something that has a certain sense of immediacy.”


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