Understanding and Facilitating Rural Health Transformation

Triple Aim© Video Discussion Guide

Understanding and Facilitating Rural Health Transformation



Delivering health care value in rural communities is an increasingly important health care system responsibility. Health care value can be defined by the Triple Aim©:

  • Better patient experience (both clinical quality and patient satisfaction)
  • Improved community and population health
  • Reduced cost of care
This 10-minute video will describe the Triple Aim© and shift underway to value-based purchasing of health care. Viewing the video independently will be educational, but we encourage you to share it with groups and use it as an opportunity to engage and stimulate discussion among key stakeholders, clinicians, and staff.



This Triple Aim© Video Discussion Guide will inform and stimulate discussion in your rural community and help viewers:

  • Understand the definition of health care value
  • Recognize how a shift to health care value will impact local health care providers
  • Identify opportunities to increase health care value
  • Provide a rural context for implementing the Triple Aim©



Engaging a broad variety of stakeholders in discussions about how to improve health care value will help develop understanding, gain support, and generate creative solutions to fit your community's needs. Groups to consider include:

  • Health Care
    • Medical and nursing staff
    • Hospital Department Heads
    • Nursing Home/Assisted Living Directors
    • Home Care/Hospice Directors
    • Clinic Managers
    • Behavioral Health Clinics/Providers
  • Social Service
    • Local government social service leaders
    • Faith-based organizations
    • Public Health agencies
    • Home Health agencies
    • Free clinics or other providers
  • Community
    • Health Care Boards of Directors
    • Chamber of Commerce
    • Large Employers
    • Community/Service Agencies


Discussion Questions

  1. How health care providers are paid is often not clear to patients. What would our patients, families, and community say about being rewarded to deliver the Triple Aim©, and why?
  2. Before an organization can improve health care value, value must be measured. What indices of health care value are being measured now, and what indices should be measured going forward?
  3. Currently, most health care providers are paid based on volume of services provided. What challenges will health care providers face as payment shifts to health care value, not volume?
  4. In the near future, health care providers will continue to be primarily paid based on volume of services. What strategies might be implemented to "test the waters" of value-based care that are of relatively low financial risk?
  5. Delivering the Triple Aim© requires coordination of care. What obstacles currently exist to care coordination and how can those barriers be broken? What barriers are unique to rural providers?
  6. The saying "It takes a village" has been invoked when comprehensive change is needed. What community strengths, resources, and capacities can be utilized to improve local health care value?


Triple Aim© Resources

Click here to download a .pdf version of this document.

Tell Rural Health Value about your rural health care delivery or financing innovation!
Click here to Share Your Rural Innovation!