MEDICARE UPDATES: VBP, SNF QRP, BUNDLING
|
|
- Patience Tucker
- 5 years ago
- Views:
Transcription
1 MEDICARE UPDATES: VBP, SNF QRP, BUNDLING PRESENTED BY: ROBIN L. HILLIER, CPA, STNA, LNHA, RAC-MT (330) MEDICARE VALUE BASED PURCHASING 1
2 PROTECTING ACCESS TO MEDICARE ACT OF 2014 (PAMA) IMPLEMENTS A VALUE BASED PURCHASING PROGRAM (SNF VBP) 2% WITHHOLD TO PART A PAYMENTS THAT CAN BE PARTIALLY EARNED BACK BASED ON REHOSPITALIZATION RATE AND LEVEL OF IMPROVEMENT PASSED IN 2014, RATES NOT IMPACTED UNTIL FY 2019 (OCTOBER 1, 2018); DETAILS TO BE DEVELOPED BY CMS RULEMAKING PAMA VBP IMPLEMENTATION TIMELINE FY 2016 MEASURE DEVELOPMENT, DATA COLLECTION FY 2017 SNF PREVIEW OF DATA FY 2018 PUBLIC REPORTING OF DATA FY 2019 (OCTOBER 1, 2018) WITHHOLD IMPLEMENTED 2
3 FY 2016 PPS UPDATE RULE CMS SELECTED THE SKILLED NURSING FACILITY 30-DAY ALL-CAUSE READMISSION MEASURE RISK ADJUSTED REHOSPITALIZATION MEASURE (SNFRM NQF #2510) WILL MOVE TO POTENTIALLY PREVENTABLE REHOSPITALIZATION MEASURE SNFRM BACKGROUND HOSPITAL READMISSIONS OF MEDICARE VBENEFICIARIES DISCHARGED FROM A SNF ARE COMMON, STUDIES SUGGEST A LARGE PROPORTION ARE PREVENTABLE HOSPITAL READMISSIONS ALSO PUT BENEFICIARIES AT RISK FOR COMPLICATIONS THE INTENT OF THE SNFRM IS TO ENCOURAGE SNF PROVIDERS TO MONITOR AND REDUCE HOSPITAL READMISSIONS, THEREBY REDUCING COSTS AND IMPROVING THE QUALITY OF CARE MEDICARE BENEFICIARIES RECEIVE DURING THEIR SNF STAY 3
4 SNFRM MEASURE OVERVIEW SNFRM ESTIMATED THE RISK-STANDARDIZED RATE OF ALL-CAUSE, UNPLANNED HOSPITAL READMISSIONS FOR SNF BENEFICIARIES WITHIN 30 DAYS OF DISCHARGE FROM THEIR PRIOR PROXIMAL SHORT-STAY ACUTE HOSPITAL DISCHARGE SNF ADMISSION MUST HAVE OCCURRED WITHIN 1 DAY AFTER DISCHARGE FROM THE PROXIMAL HOSPITAL STAY MEASURE BASED ON DATA FOR 12 MONTHS OF SNF ADMISSIONS BENEFICIARIES WITH MORE THAN ONE ELIGIBLE ADMISSION MAY BE INCLUDED IN THE MEASURE MULTIPLE TIMES WITHIN A GIVEN YEAR SNFRM MEASURE OVERVIEW - EXCLUSIONS SNFRM EXCLUDES CERTAIN STAYS: STAYS FOR WHICH PATIENT HAD INTERVENING PAC ADMISSION BETWEEN HOSPITAL STAY AND SNF OR AFTER SNF DISCHARGE PATIENTS WHO DID NOT HAVE FFS PART A ENROLLMENT BEFORE PROXIMAL HOSPITAL DISCHARGE PATIENTS WHO DID NOT HAVE FFS PART A ENROLLMENT FOR ENTIRE 30 DAY RISK WINDOW PATIENTS WHOSE HOSPITALIZATION WAS FOR THE MEDICAL (NONSURGICAL) TREATMENT OF CANCER OR RECEIVING REHABILITATION CARE OR PROSTHESIS FITTING 4
5 SNFRM MEASURE OVERVIEW SNF RM PRODUCES A RISK-ADJUSTED READMISSION RATE FOR EACH FACILITY, EXCLUDING PLANNED READMISSION FROM THE SNF MEASURE IS COMPUTED BY CALCULATING THE STANDARDIZED RISK RATIO (SRR): THE PREDICTED NUMBER OF READMISSIONS AT THE FACILITY DIVIDED BY THE EXPECTED NUMBER OF READMISSIONS FOR THE SAME PATIENTS IF THESE SAME PATIENTS HAD BEEN TREATED BY THE AVERAGE SNF SRR IS THEN MULTIPLIED BY THE MEAN RATE OF READMISSION IN THE POPULATION TO GENERATE THE FACILITY-LEVEL STANDARDIZED READMISSION RATE, REFERRED TO AS THE RISK- STANDARDIZED READMISSION RATE OR RSRR SNFRM MEASURE OVERVIEW MEASURE IS DESIGNED TO CAPTURE THE OUTCOME OF UNPLANNED ALL-CAUSE HOSPITAL READMISSIONS OCCURRING WITHIN 30 DAYS OF DISCHARGE FROM THE PATIENTS PRIOR PROXIMAL ACUTE HOSPITALIZATION HOSPITAL OBSERVATION STAYS DO NOT COUNT AS A READMISSION READMISSIONS IDENTIFIED AS BEING PLANNED USING THE CMS PLANNED READMISSION ALGORITHM ARE EXCLUDED SNFRM IS EVALUATED ON A 1-YEAR CYCLE 5
6 SNFRM PLANNED READMISSION PLANNED READMISSION IS DEFINED AS ANT NON-ACUTE READMISSION IN WHICH ONE OF A SET OF TYPICALLY PLANNED PROCEDURES OR DIAGNOSES OCCURRED IF ANY OF THE PROCEDURES DENOTED AS PLANNED OCCUR IN CONJUNCTION WITH A DIAGNOSIS THAT DISQUALIFIES A READMISSION FROM BEING CONSIDERED PLANNED, THE READMISSION WILL BE CONSIDERED TO BE UNPLANNED SNFRM PLANNED READMISSION PLANNED READMISSION PROCEDURES: ONE OF A PRE-SPECIFIED LIST OF PROCEDURES TOOK PLACE, OR READMISSION FOR BONE MARROW, KIDNEY OR OTHER TRANSPLANT PLANNED READMISSION DIAGNOSES: MAINTENANCE CHEMOTHERAPY AND REHABILITATION READMISSIONS TO PSYCHIATRIC HOSPITALS OR UNITS ADMISSIONS FOR ACUTE ILLNESS OR FOR COMPLICATIONS OF CARE ARE NOT CLASSIFIED AS PLANNED, EVEN IF A TYPICALLY PLANNED PROCEDURE IS PERFORMED DURING THE STAY PRINCIPAL DIAGNOSIS AND ALL PROCEDURE CODES FROM THE READMISSION ARE UTILIZED TO IDENTIFY PLANNED READMISSIONS 6
7 SNFRM RISK ADJUSTMENT COVARIATES USED IN THE MEASURE: AGE, GENDER PROXIMAL HOSPITALIZATION LOS TIME IN ICU? ESRD # ACUTE CARE HOSPITALIZATIONS IN 365 DAYS BEFORE PROXIMAL HOSPITALIZATION PRINCIPAL DIAGNOSIS SYSTEM-SPECIFIC SURGICAL INDICATORS KIDNEY, CARDIAC, VASCULAR PATIENTS WITH SURGICAL INDICATORS ARE HIGHER RISK ORTHO WITH SURGICAL INDICATOR ARE LOWER RISK INDIVIDUAL COMORBIDITIES ESRD, DIABETES, HEART FAILURE, PRESSURE ULCERS MULTIPLE COMORBIDITIES CHARLSON COMORBIDITY INDEX IS CALCULATED USING BOTH THE NUMBER AND SERIOUSNESS OF COMORBIDITIES FY 2017 PPS UPDATE RULE FY 2016 PPS UPDATE RULE SPECIFIED THE USE OF THE SNF REHOSPITALIZATION MEASURE (SNF RM) FOR VALUE BASED PURCHASING RATE ADJUSTMENTS EFFECTIVE OCTOBER 1, 2018 FY 2017 UPDATE RULE ANNOUNCES TRANSITION TO A POTENTIALLY PREVENTABLE REHOSPITALIZATION MEASURE ( SNFPPRM ) AT SOME POINT 30 DAY MEASURE SIMILAR TO THE SNF RM, BUT ONLY COUNTS REHOSPITALIZATIONS WITH A DIAGNOSIS ON HOSPITAL CLAIM THAT IS CONSIDERED POTENTIALLY PREVENTABLE (I.E., COPD, CHF) THIS IS A SPECIFIC LIST OF DIAGNOSES, COVERS MOST ADMISSIONS RLH Consulting 14 7
8 FY 2017 PPS UPDATE RULE PERFORMANCE PERIOD JANUARY 1, 2017 TO DECEMBER 31, 2017 IMPROVEMENT PERIOD IMPROVEMENT TO BE CALCULATED OVER RATE FROM TWO YEARS BEFORE PERFORMANCE PERIOD CY 2017 IMPROVEMENT OVER CY 2015 CMS ANNOUNCED PLANS TO TRANSITION FROM A CALENDAR YEAR MEASUREMENT PERIOD TO A FISCAL YEAR MEASUREMENT PERIOD BEGINNING OCTOBER 2017, SO THE QUARTER FROM OCTOBER 1 THROUGH DECEMBER 31, 2017 WILL COUNT IN TWO DIFFERENT RATE YEAR ADJUSTMENTS RLH Consulting 15 FY 2017 PPS UPDATE RULE REHOSPITALIZATION SCORE USED TO CALCULATE PAYMENT RATE CAN RANGE FROM 0 TO 100 POINTS IT WILL BE THE HIGHER OF THE FACILITY ACHIEVEMENT SCORE OR IMPROVEMENT SCORE FACILITIES WILL BE RANKED BASED ON REHOSPITALIZATION SCORE TO DETERMINE PAYMENT ADJUSTMENT RLH Consulting 16 8
9 FY 2017 PPS UPDATE RULE ACHIEVEMENT SCORE OF 0 TO 100 IS AWARDED BASED ON RANKING OF THE REHOSPITALIZATION RATE IN THE PERFORMANCE PERIOD SNFS IN LOWEST 25% RECEIVE 0 POINTS SNFS IN TOP 5% RECEIVE 100 POINTS FORMULA PROPOSED FOR ALLOCATING POINTS TO REMAINING SNFS RLH Consulting 17 FY 2017 PPS UPDATE RULE IMPROVEMENT SCORE OF 0 TO 90 POINTS AWARDED BASED ON IMPROVEMENT OVER A TWO- YEAR PERIOD A UNIQUE IMPROVEMENT RANGE IS ESTABLISHED FOR EACH SNF THAT DEFINES THE DIFFERENCE BETWEEN THEIR BASELINE PERIOD SCORE AND THE NATIONAL BENCHMARK ESTABLISHED RLH Consulting 18 9
10 FY 2017 PPS UPDATE RULE IMPROVEMENT SCORE, CONTINUED IF PERFORMANCE PERIOD SCORE IS EQUAL TO OR LOWER THAN IMPROVEMENT THRESHOLD, 0 POINTS AWARDED IF PERFORMANCE PERIOD SCORE IS EQUAL TO OR HIGHER THAN THE BENCHMARK, 90 POINTS AWARDED IF PERIOD SCORE IS GREATER THAN IMPROVEMENT SCORE, BUT LESS THAN THE BENCHMARK, BETWEEN 0 AND 90 POINTS WILL BE AWARDED USING A PROPOSED FORMULA RLH Consulting 19 FY 2017 PPS UPDATE RULE SNF PART A PAYMENT ADJUSTMENT WILL BE BASED ON REHOSPITALIZATION SCORE RANKING FACILITIES WILL BE TOLD THE PAYMENT ADJUSTMENT AT LEAST 60 DAYS PRIOR TO RATE EFFECTIVE DATE REMEMBER, FIRST PAYMENT ADJUSTMENTS EFFECTIVE OCTOBER 1, 2018 RLH Consulting 20 10
11 UPCOMING SNF VBP COMPONENTS CMS IS NOW PROVIDING QUARTERLY CONFIDENTIAL FEEDBACK REPORTS SO THAT FACILITIES CAN MONITOR THEIR PERFORMANCE CMS HAS POSTED A FILE WITH EVERY SNF 2015 BASELINE (2015) RISK STANDARDIZED READMISSION RATE THE FY2018 PPS UPDATE RULE WILL PROVIDE ADDITIONAL INFORMATION RELATED TO THE PAYMENT SPECIFICS IMPACT ACT 11
12 IMPACT ACT THE IMPACT ACT (2014) REQUIRED CMS TO SPECIFY STANDARD ASSESSMENT TOOLS ACROSS PAC PROVIDERS (HH, SNF, IRF, LTCH) ALONG WITH CROSS-SETTING QMS BY OCTOBER 2015 IN FOUR DOMAINS: FUNCTIONAL STATUS COGNITIVE FUNCTION AND CHANGES IN COGNITION SKIN INTEGRITY AND CHANGES IN SKIN INTEGRITY INCIDENCE OF MAJOR FALLS SNF QUALITY REPORTING PROGRAM (QRP) COLLECTION AND SUBMISSION OF DATA REQUIRED WITHIN TWO YEARS OF FINAL MEASURE SPECIFICATION (OCTOBER 2017) PROPOSED MEASURES REQUIRE TWELVE MONTHS OF DATA, SO DATA SUBMISSION REQUIRED BEGINNING OCTOBER % PENALTY FOR FAILURE TO REPORT REQUIRED DATA (IMPLICATION OF DASHES ON MDS) FUTURE IMPLICATIONS FOR VBP 12
13 SNF PART A DISCHARGE ASSESSMENT THE MEASURES SPECIFIED FOR SNFQR REQUIRES AN ASSESSMENT BE COMPLETED AT THE END OF EACH PART A STAY TO CAPTURE QUALITY MEASURE ITEMS. DISCHARGE ASSESSMENTS ARE COMPLETED FOR PART A BENEFICIARIES WHO GO HOME AT THE END OF THE EPISODE OF CARE, BUT THERE IS CURRENTLY NOT AN END OF CARE ASSESSMENT REQUIRED FOR THOSE WHO WILL REMAIN IN THE FACILITY AT THE END OF PART A COVERAGE EFFECTIVE OCTOBER 1, 2016 A NEW SNF PART A PPS DISCHARGE ASSESSMENT IS REQUIRED IN THESE CIRCUMSTANCES SNF PART A DISCHARGE ASSESSMENT THE MEASURES SPECIFIED FOR SNFQR REQUIRES AN ASSESSMENT BE COMPLETED AT THE END OF EACH PART A STAY TO CAPTURE QUALITY MEASURE ITEMS. DISCHARGE ASSESSMENTS ARE COMPLETED FOR PART A BENEFICIARIES WHO GO HOME AT THE END OF THE EPISODE OF CARE, BUT THERE IS CURRENTLY NOT AN END OF CARE ASSESSMENT REQUIRED FOR THOSE WHO WILL REMAIN IN THE FACILITY AT THE END OF PART A COVERAGE EFFECTIVE OCTOBER 1, 2016 A NEW SNF PART A PPS DISCHARGE ASSESSMENT IS REQUIRED IN THESE CIRCUMSTANCES 13
14 SNF PART A DISCHARGE ASSESSMENT REVIEW CODING INSTRUCTIONS FOR A2400C AS WELL AS RETURN ANTICIPATED VS. RETURN NOT ANTICIPATED FOR A MEDICARE PART A DISCHARGE WHERE THE BENEFICIARY LEAVES THE FACILITY, THIS ASSESSMENT WILL BE COMBINED WITH THE OBRA DISCHARGE ASSESSMENT FOR A RESIDENT WHO WILL REMAIN IN THE FACILITY AFTER BEING DISCHARGED FROM MEDICARE, THIS WILL BE A STAND ALONE ASSESSMENT SNF QRP ASSESSMENT-BASED QUALITY MEASURES NQF #0674: APPLICATION OF PERCENT OF RESIDENTS EXPERIENCING ONE OF MORE FALLS WITH A MAJOR INJURY NQF #0678: PERCENT OF PATIENTS OR RESIDENTS WITH PRESSURE ULCERS THAT ARE NEW OR WORSENED NQF #2631 APPLICATION OF PERCENT OF LONG-TERMCARE HOSPITAL ADMISSIONS WITH AN ADMISSION AND DISCHARGE FUNCTIONAL ASSESSMENT AND A CARE PLAN THAT ADDRESSES FUNCTION 14
15 SNF QRP CLAIMS-BASED MEASURES DISCHARGE TO COMMUNITY POST ACUTE CARE (PAC) SKILLED NURSING FACILITY QUALITY REPORTING PROGRAM (QRP) POTENTIALLY PREVENTABLE 30-DAYS POST-DISCHARGE READMISSION MEASURE FOR SKILLED NURSING FACILITY QUALITY REPORTING PROGRAM MEDICARE SPENDING PER BENEFICIARY POST ACUTE CARE (PAC) SKILLED NURSING FACILITY MEASURE SNF QRP MEASURES CMS HAS POSTED SEVERAL RESOURCES: TABLE OF MDS ITEMS USED TO GENERATE SNF QRP MEASURES SNF QRP QUALITY MEASURES USER S MANUAL REVIEW AND CORRECT REPORTS 15
16 BUNDLING UPDATE MAJOR BUNDLING INITIATIVES Bundled Payments for Care Improvement (BPCI) Comprehensive Care for Joint Replacement (CJR) Episode Payment Models (EPMs) April 2013 Voluntary for all Medicare acute and PAC providers 4 models: acute, PAC, and acute+pac Providers can select from 48 clinical episodes to test within a specific timeframe (ranging from inpatient acute care to 30, 60, or 90 days after discharge) April year demo Mandatory bundles in 67 markets for Medicare beneficiaries who receive hip and knee replacements (also called lower extremity joint replacements or LEJR) Hospital is risk-bearer, impacts ~800 hospitals 90-day episodes January 1, 2018? 5-year demo? Mandatory bundles in 98 markets for heart attack, bypass surgery Mandatory surgical hip/femur fracture treatment episode added to 67 CJR markets Proposed in 2016, subsequently delayed twice (current start date is January 2018) Hospital is risk-bearer 90-day episodes 16
17 CMS SCALES BACK MANDATORY BUNDLING DEMOS 1. Completely withdraw proposed AMI, CABG, and SHFFT episodes 2. Reduce mandatory CJR markets from 67 to 34 (remaining 33 become voluntary) 3. No longer mandatory for rural and low-volume hospitals August 17, 2017 Proposed Rule Source: HALF OF CJR MARKETS WOULD GO VOLUNTARY 17
18 IS SCALE-BACK A GOOD THING? SCALING BACK OF MANDATORY BUNDLING PROGRAMS COULD EASE THE PRESSURE ON SNFS, PARTICULARLY IN REFORM-HEAVY MARKETS WITH MANY COMPETING OVERLAPPING VALUE-BASED INITIATIVES SNF OPPORTUNITY TO SHARE RISK IN HOSPITAL-CONTROLLED, MANDATORY PROGRAMS IS LIMITED CONCERNS OVER UNINTENDED CONSEQUENCES ON PATIENT ACCESS TO SNF SERVICES DOESN T MEAN BUNDLING GOES AWAY CMS TO EXPAND VOLUNTARY OPTIONS WE EXPECT TO CONTINUE TO OFFER OPPORTUNITIES FOR PROVIDERS TO PARTICIPATE IN VOLUNTARY INITIATIVES, INCLUDING EPISODE PAYMENT MODELS. BUILDING ON THE BPCI INITIATIVE, CMMI EXPECTS TO DEVELOP NEW VOLUNTARY BUNDLED PAYMENT MODEL(S) DURING CY 2018 THAT WOULD BE AN ADVANCED APM. 18
19 ADVANCED BPCI: DETAILS STARTING TO EMERGE MODELS 1 AND 4 OF BPCI NOT LIKELY TO BE CONTINUED LOOKING TO BUILD OFF EXISTING BPCI RISK-BEARING ARCHITECTURE LIKELY TO CONTINUE TO USE CONVENER AND EPISODE INITIATORS STRUCTURE TWEAKS UNDER CONSIDERATION BY CMS INNOVATION CENTER: ALLOWING NEW PARTICIPANTS NEWLY DEFINED EPISODES LONGER PERFORMANCE PERIODS TARGET PRICE CALCULATION ENSURING THAT THE NEW MODEL QUALIFIES AS MACRA ADVANCED APM ADVANCED BPCI: WHAT WE RE WATCHING FOR DOES IT MAINTAIN A MODEL 3-LIKE OPTION FOR PAC PROVIDERS TO DIRECTLY BEAR RISK FOR A PAC-ONLY EPISODE OF CARE? WILL EPISODE OPTIONS BE MAINTAINED? WILL THERE BE NEW EPISODE OPTIONS? (E.G., CHRONIC CARE EPISODE) WILL THERE BE BETTER RISK ADJUSTMENT AND RISK MITIGATION? WHAT TYPE OF DATA AND HOW FREQUENTLY WILL CMS PROVIDE TO APPLICANTS/PARTICIPANTS? WHAT WILL THE TECHNOLOGY REQUIREMENTS BE? 19
20 WHY ENGAGE IN VOLUNTARY BUNDLES? Learn by doing; force culture change Understand markets through data Improve quality through care redesign Earn positive margins Master skills for gainsharing in other arenas Immediate Consider participating in Advanced BPCI ACTION STEPS Understand who in your market is bearing downside risk Find out if referral hospitals are staying in CJR could impact BPCI If you are serious about participating in Advanced BPCI Evaluate potential convener relationship Identify clinical/ episode focus areas Systematically reach out with your (quality & cost) value proposition 20
Final Rule Summary. Medicare Skilled Nursing Facility Prospective Payment System Fiscal Year 2017
Final Rule Summary Medicare Skilled Nursing Facility Prospective Payment System Fiscal Year 2017 August 2016 Table of Contents Overview and Resources... 2 Skilled Nursing Facility (SNF) Payment Rates...
More informationSet Yourself Up for Success: How VBP is Changing the Game NYSHFA January 26, 2018 Presented by, Maureen McCarthy, RN, BS, RAC-MT, QCP-MT
Set Yourself Up for Success: How VBP is Changing the Game NYSHFA January 26, 2018 Presented by, Maureen McCarthy, RN, BS, RAC-MT, QCP-MT 1 Maureen McCarthy, RN, BS, RAC-MT, QCP-MT 2 Maureen is the President
More informationFinal Rule Summary. Medicare Skilled Nursing Facility Prospective Payment System Fiscal Year 2016
Final Rule Summary Medicare Skilled Nursing Facility Prospective Payment System Fiscal Year 2016 August 2015 Table of Contents Overview and Resources... 2 SNF Payment Rates... 2 Effect of Sequestration...
More informationThe Pain or the Gain?
The Pain or the Gain? Comprehensive Care Joint Replacement (CJR) Model DRG 469 (Major joint replacement with major complications) DRG 470 (Major joint without major complications or comorbidities) Actual
More informationData-Driven Strategy for New Payment Models. Objectives. Common Acronyms
Data-Driven Strategy for New Payment Models Mark Sharp, CPA Partner msharp@bkd.com Objectives Understand new payment model reforms and bundling arrangements Learn how these new payment models can impact
More informationEpisode Payment Models Final Rule & Analysis
Episode Payment Models Final Rule & Analysis February 15, 2017 Agenda Overview Changes from Proposed Rule Categorization of Episodes Episode Attribution Reconciliation Quality Performance Cardiac Rehab
More informationAdvancing Care Coordination Proposed Rule
Advancing Care Coordination Proposed Rule Released July 25, 2016 Erin Smith, JD VP and Executive Director, PACCR Jourdan Meltzer Research Associate, PACCR August 4, 2016 1 Presentation Overview Three new
More informationCPAs & ADVISORS. experience support // ADVANCED PAYMENT MODELS: CJR
CPAs & ADVISORS experience support // ADVANCED PAYMENT MODELS: CJR Andy M. Williams Partner BKD Eric M. Rogers Managing Consultant BKD Will McLeod VP of Patient Services McLeod Health Emily Adams Associate
More informationCMS Proposed Payment Rule FY Cheryl Phillips, MD Evvie Munley
CMS Proposed Payment Rule FY 2017 Cheryl Phillips, MD Evvie Munley Key Points The link for the full rule: https://www.gpo.gov/fdsys/pkg/fr-2016-04- 25/pdf/2016-09399.pdf Comments due CoB 6/20/16 You do
More information4/9/2016. The changing health care market THE CHANGING HEALTH CARE MARKET. CPAs & ADVISORS
CPAs & ADVISORS experience support // ADVANCED PAYMENT MODELS: CJR Eric. M. Rogers MEd. RT(R) Managing Consultant The changing health care market THE CHANGING HEALTH CARE MARKET HHS goal of 30% of traditional
More informationEmerging Issues in Post Acute Care Trends
Emerging Issues in Post Acute Care Trends Lavonne Elston, PT Senior Director of Operations & Strategic Initiatives Skilled Nursing & Rehabilitation Kingston HealthCare Company April 28, 2016 Disclosures
More informationRedesigning Post-Acute Care: Value Based Payment Models
Redesigning Post-Acute Care: Value Based Payment Models Liz Almeida-Sanborn, MS, PT President Preferred Therapy Solutions This session will address: Discussion of the emergence of voluntary and mandatory
More informationProposed fy17 LTCH PPS: New rules for Quality & Referrals
Proposed fy17 LTCH PPS: New rules for Quality & Referrals Mary Dalrymple Managing Director, LTRAX Kristen Smith, MHA, PT Senior Consultant, Fleming-AOD Overview Objectives Describe updates to the LTCH
More informationCY 2018 Home Health PPS Proposed Rule
CY 2018 Home Health PPS Proposed Rule Rochelle Archuleta & Caitlin Gillooley AHA Policy August 24, 2017 CY 2018 Proposed Rule Published in July 28 Federal Register Net Reduction: 0.4%, -$80m Same for facility-based
More informationAlternative Payment Models: Trends and Tactics for Success
Alternative Payment Models: Trends and Tactics for Success James Michel Senior Director, Medicare Reimbursement & Policy American Health Care Association November 15, 2016 Discussion Review CMS priorities
More informationValue Based Care in LTC: The Quality Connection- Phase 2
Value Based Care in LTC: The Quality Connection- Phase 2 Joseph J. Tomaino, M.S., R.N., Principal Healthcare Transformation Consulting ChemRx/PharmMerica Geriatric Skilled Nursing Seminar December 7, 2017
More informationHOSPITALS & HEALTH SYSTEMS: DATA-DRIVEN STRATEGY FOR BUNDLED PAYMENT SUCCESS 4/19/2016. April 20, 2016
HOSPITALS & HEALTH SYSTEMS: DATA-DRIVEN STRATEGY FOR BUNDLED PAYMENT SUCCESS April 20, 2016 Eddie Marmouget National Industry Partner emarmouget@bkd.com Eric Rogers Managing Consultant erogers@bkd.com
More informationQuality Outcomes and Data Collection
Quality Outcomes and Data Collection Presented By: Joanne Jones Director, Clinical Consulting Services August 30, 2016 Quality Measurement in LTC CMS Nursing Home Compare 5 Star Rating System New measures
More informationSNF * Readmissions Bootcamp The SNF Readmission Penalty, Post-Acute Networks, and Community Collaboratives
SNF * Readmissions Bootcamp The SNF Readmission Penalty, Post-Acute Networks, and Community Collaboratives Lindsay Holland, MHA Associate Director, Care Transitions Health Services Advisory Group (HSAG)
More informationMedicare Skilled Nursing Facility Prospective Payment System
Final Rule Summary Medicare Skilled Nursing Facility Prospective Payment System Program Year: FY2019 August 2018 1 TABLE OF CONTENTS Overview and Resources... 2 SNF Payment Rates... 2 Wage Index and Labor-Related
More informationThe Role of Analytics in the Development of a Successful Readmissions Program
The Role of Analytics in the Development of a Successful Readmissions Program Pierre Yong, MD, MPH Director, Quality Measurement & Value-Based Incentives Group Centers for Medicare & Medicaid Services
More informationMaking CJR Work for You. A Roadmap for Successful Implementation of Medicare Bundles
December 10, 2015 Making CJR Work for You A Roadmap for Successful Implementation of Medicare Bundles https://innovation.cms.gov/initiatives/cjr Sheldon Hamburger shamburger@thearistonegroup.com (248)
More information(202) or CMS Proposals to Improve Quality of Care during Hospital Inpatient Stays
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE April 30, 2014 Contact: CMS Media
More informationPREPARING FOR RISK-BASED OUTCOMES OF BUNDLED CARE
CPAs & ADVISORS experience support // PREPARING FOR RISK-BASED OUTCOMES OF BUNDLED CARE Jackie Nussbaum MHA, CPC, CHFP, FHFMA Director Eric Rogers M.Ed. RT Managing Consultant THE CHANGING HEALTH CARE
More informationFurthering the agency s stated intention to pay for value over volume,
in the news Health Care September 2016 The Future Is Now: CMS Proposes Broad Bundled Payment Expansion for Cardiac Care Episodes In this Issue: Episode Payment Models... 2 Cardiac Rehabilitation Incentives...
More informationThe President s and Other Bipartisan Proposals to Reform Medicare: Post-Acute Care (PAC) Reform. Summary
Current Law The President s and Other Bipartisan Proposals to Reform Medicare: Post-Acute Care (PAC) Reform Summary Home Health Agencies Under current law, beneficiaries who are generally restricted to
More informationQuestions and Answers on the CMS Comprehensive Care for Joint Replacement Model
Questions and Answers on the CMS Comprehensive Care for Joint Replacement Model MEGGAN BUSHEE, ESQ. 704.343.2360 mbushee@mcguirewoods.com 201 North Tryon Street, Suite 3000 Charlotte, North Carolina 28202-2146
More information5/26/2016. What's New? What's Changed? Urgent Updates QM Manual v10. Faculty Disclosure. Requirements for Successful Completion
What's New? What's Changed? Urgent Updates QM Manual v10 Presented by: Judi Kulus, MSN, MAT, RN, NHA, RAC-MT, DNS-CT VP of Curriculum Development jkulus@aanac.org Faculty Disclosure I have no financial
More informationThe New World of Value Driven Cardiac Care
1 The New World of Value Driven Cardiac Care Disclosures MPA Healthcare Solutions is an analytic health care consultancy that provides clients with insight into clinical performance; aids them in the evaluation,
More informationCJR Final Rule: Policy Changes and Strategies for Bundled Payment Success
CJR Final Rule: Policy Changes and Strategies for Bundled Payment Success Melinda Hancock, Edward Stall, Craig Tolbert, Michael Wolford Friday, November 20, 2015 1 Agenda 1) Overview of CJR Model 2) Policy
More informationMEDICARE COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL (CCJR) Preparing for Risk-Based Outcomes of Bundled Care 8/12/2015.
MEDICARE COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL (CCJR) Preparing for Risk-Based Outcomes of Bundled Care August 13, 2015 Eric M. Rogers MEd RT(R) Managing Consultant erogers@bkd.com Jeff Bond President
More information2017 Quality Reporting: Claims and Administrative Data-Based Quality Measures For Medicare Shared Savings Program and Next Generation ACO Model ACOs
2017 Quality Reporting: Claims and Administrative Data-Based Quality Measures For Medicare Shared Savings Program and Next Generation ACO Model ACOs June 15, 2017 Rabia Khan, MPH, CMS Chris Beadles, MD,
More informationWhat is SNF Value Based Purchasing?
SNF Value Based Purchasing How reducing rehospitalizations impacts revenue and margins James Muller, Senior Director of Research, AHCA Marinela Shqina, Chief Financial Officer, Manchester and Vernon Manor
More informationThe IRF PPS FY 2017 Final Rule: What It Portends for Our Future
The IRF PPS FY 2017 Final Rule: What It Portends for Our Future Presenter: Carolyn C. Zollar, MA, J.D. Executive Vice President of Government Relations and Policy Development czollar@amrpa.org AMRPA Webinar
More informationWelcome to the Reducing Readmissions Preparation Program: Understanding Changes in Readmission Measures for Nursing Homes
Welcome to the Reducing Readmissions Preparation Program: Understanding Changes in Readmission Measures for Nursing Homes Lindsay Holland, MHA Director, Care Transitions, HSAG California Jennette Silao,
More informationPAYMENT INNOVATION: Real Examples of Client Implementation. Craig Tolbert & Michael Wolford
PAYMENT INNOVATION: Real Examples of Client Implementation Craig Tolbert & Michael Wolford 2 PINNACLE SPEAKER PROFILE CRAIG TOLBERT Principal DHG Healthcare Birmingham, AL PINNACLE SPEAKER PROFILE MICHAEL
More informationPost-Acute Care. December 6, 2017 Webinar Louise Bryde and Doug Johnson
Post-Acute Care December 6, 2017 Webinar Louise Bryde and Doug Johnson Topics for Discussion Background What Is Post Acute Care? Lexicon Levels of Care Why Focus on Post Acute Care? Emerging PAC Trends
More informationA Brave New World: Lessons Learned From Healthcare Reform. Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage
A Brave New World: Lessons Learned From Healthcare Reform Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage 1 Learning Objectives Participants will understand: The impact health
More informationPartners in the Continuum of Care: Hospitals and Post-Acute Care Providers
Partners in the Continuum of Care: Hospitals and Post-Acute Care Providers Presented to the Wisconsin Association for Home Health Care November 3, 2017 By: Laura Rose WHA Vice President, Policy Development
More informationWhat 2017 Holds for Medicare Value-Based Transformation: Finalization of the Advancing Care Coordination Rule and Much More
January 19, 2017 What 2017 Holds for Medicare Value-Based Transformation: Finalization of the Advancing Care Coordination Rule and Much More HDG Webinar Series Brian Ellsworth, MA, Director, Payment Transformation
More informationQIES Help Desk. Objectives. Nursing Home Quality Initiatives and Five-Star Quality Rating System
Nursing Home Quality Initiatives and Five-Star Quality Rating System Diane Henry, RN, LHHA State RAI Coordinator Quality Improvement & Evaluation Service Oklahoma State Department of Health QIES Help Desk
More informationLearning Objectives. CMS Plans to Transform Healthcare. Leveraging CDI to Improve Performance Under Alternative Payment Model (APM) Methodology
1 Leveraging CDI to Improve Performance Under Alternative Payment Model (APM) Methodology Wayne Little, Partner Michelle Wieczorek, Senior Manager Ericson, Cheryl, Manager DHG Healthcare, Atlanta, GA Learning
More informationSucceeding in a New Era of Health Care Delivery
March 14, 2012 Succeeding in a New Era of Health Care Delivery Building Value-Based Partnerships LeadingAge Pennsylvania Kathleen Griffin, PhD, National Director Post-Acute and Senior Services 1 Your Presenter
More informationMedicare Spending and Rehospitalization for Chronically Ill Medicare Beneficiaries: Home Health Use Compared to Other Post-Acute Care Settings
Medicare Spending and Rehospitalization for Chronically Ill Medicare Beneficiaries: Home Health Use Compared to Other Post-Acute Care Settings May 11, 2009 Avalere Health LLC Avalere Health LLC The intersection
More informationGet A Seat at the Table
Get A Seat at the Table Develop Cross-Continuum Networks in the Competitive, Performance-Driven Senior Living Industry Hilary Forman, PT, RAC-CT Senior VP, Clinical Strategies Division, HealthPRO Heritage
More informationEpisode Payment Models:
Episode Payment Models: Cardiac Bundle Initiative HFMA Florida Chapter (North Florida) October 25, 2016 Robert Howey MBA, MHA, CPA Revenue Cycle Manager 2016 MFMER slide-1 Objective After the session,
More informationMEDICARE FFY 2017 PPS PROPOSED RULES OVERVIEW OHA Finance/PFS Webinar Series. May 10, 2016
MEDICARE FFY 2017 PPS PROPOSED RULES OVERVIEW 2016 OHA Finance/PFS Webinar Series May 10, 2016 Spring is Medicare PPS Proposed Rules Season Inpatient Hospital Long-Term Acute Care Hospital Inpatient Rehabilitation
More informationFY 2014 Inpatient PPS Proposed Rule Quality Provisions Webinar
FY 2014 Inpatient PPS Proposed Rule Quality Provisions Webinar May 23, 2013 AAMC Staff: Scott Wetzel, swetzel@aamc.org Mary Wheatley, mwheatley@aamc.org Important Info on Proposed Rule In Federal Register
More informationComprehensive Care for Joint Replacement (CJR) Readiness Kit
Comprehensive Care for Joint Replacement (CJR) Readiness Kit Contents CMS Announces Shift From Volume To Value...2 Top Things To Know About CJR Final Rule...3 Proposed Timeline For CJR...4 Who Is Impacted?...5
More informationQuality Provisions in the EPM Proposed Rule. Matt Baker Scott Wetzel
Quality Provisions in the EPM Proposed Rule Matt Baker Scott Wetzel Overview Quality Scoring Overview Quality Metrics in AMI and CABG EPMs Quality Metrics in SHFFT EPMs COTH Performance in these programs
More informationSummary and Analysis of CMS Proposed and Final Rules versus AAOS Comments: Comprehensive Care for Joint Replacement Model (CJR)
Summary and Analysis of CMS Proposed and Final Rules versus AAOS Comments: Comprehensive Care for Joint Replacement Model (CJR) The table below summarizes the specific provisions noted in the Medicare
More informationHospital Inpatient Quality Reporting (IQR) Program
Fiscal Year 2018 Hospital VBP Program, HAC Reduction Program and HRRP: Hospital Compare Data Update Questions and Answers Moderator Maria Gugliuzza, MBA Project Manager, Hospital Value-Based Purchasing
More informationQuality Based Impacts to Medicare Inpatient Payments
Quality Based Impacts to Medicare Inpatient Payments Overview New Developments in Quality Based Reimbursement Recap of programs Hospital acquired conditions Readmission reduction program Value based purchasing
More informationSummary of U.S. Senate Finance Committee Health Reform Bill
Summary of U.S. Senate Finance Committee Health Reform Bill September 2009 The following is a summary of the major hospital and health system provisions included in the Finance Committee bill, the America
More informationDistribution of Post-Acute Care under CJR Model of Lower Extremity Joint Replacements for MS-DRG 470
Distribution of Post-Acute Care under CJR Model of Lower Extremity Joint Replacements for MS-DRG 470 Introduction The goal of the Medicare Comprehensive Care for Joint Replacement (CJR) payment model is
More informationQuality Provisions in the EPM Final Rule. Matt Baker Scott Wetzel
Quality Provisions in the EPM Final Rule Matt Baker Scott Wetzel Overview Quality Scoring Overview Quality Metrics in AMI and CABG EPMs Quality Metrics in SHFFT EPMs COTH Performance in these programs
More informationHospital Inpatient Quality Reporting (IQR) Program
Hospital IQR Program Hybrid Hospital-Wide 30-Day Readmission Measure Core Clinical Data Elements for Calendar Year 2018 Voluntary Data Submission Questions and Answers Moderator Artrina Sturges, EdD, MS
More informationMACRA for Critical Access Hospitals. Tuesday, July 26, 2016 Webinar
MACRA for Critical Access Hospitals Tuesday, July 26, 2016 Webinar MACRA presenters Harold D. Miller, President & CEO CHQPR Claudia Sanders, Sr. Vice President, Policy Development Andrew Busz, Policy Director,
More informationNew SNF Quality Measures
New SNF Quality Measures Strategies to Boost your Facility Performance Dr. Kathleen Weissberg, OTD, OTR/L Education Director Select Rehabilitation kweissberg@selectrehab.com Objectives Understand the measure
More informationPatient Driven Payment Model (PDPM) and the MDS: A Total Evolution of the SNF Payment Model
Patient Driven Payment Model (PDPM) and the MDS: A Total Evolution of the SNF Payment Model By Devin Kassi, PT, DPT, and Melissa Keiter, RN, RAC-CT, DNS-CT, DON Centers for Medicare & Medicaid Services
More informationRegulatory Advisor Volume Eight
Regulatory Advisor Volume Eight 2018 Final Inpatient Prospective Payment System (IPPS) Rule Focused on Quality by Steve Kowske WEALTH ADVISORY OUTSOURCING AUDIT, TAX, AND CONSULTING 2017 CliftonLarsonAllen
More informationRE: CMS-1622-P; Medicare Program - Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2016
June 12, 2015 Andrew M. Slavitt Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-1622-P Room 445-G Hubert H. Humphrey Building 200
More informationMedicare P4P -- Medicare Quality Reporting, Incentive and Penalty Programs
Medicare P4P -- Medicare Quality Reporting, Incentive and Penalty Programs Presenter: Daniel J. Hettich King & Spalding; Washington, DC dhettich@kslaw.com 1 I. Introduction Evolution of Medicare as a Purchaser
More informationDelivery System Reform The ACA and Beyond: Challenges Strategies Successes Failures Future
Delivery System Reform The ACA and Beyond: Challenges Strategies Successes Failures Future Arnold Epstein MSU 2018 Health Care Policy Conference April 6, 2018 The Good Ole Days 2 Per Capita National Healthcare
More informationLeveraging Your Facility s 5 Star Analysis to Improve Quality
Leveraging Your Facility s 5 Star Analysis to Improve Quality DNS/DSW Conference November, 2016 Presented by: Kathy Pellatt, Senior Quality Improvement Analyst, LeadingAge NY Susan Chenail, Senior Quality
More informationMedicare Physician Payment Reform:
Medicare Physician Payment Reform: Implications and Options for Physicians and Hospitals Background The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law on April 14, 2015.
More informationReducing Readmissions: Potential Measurements
Reducing Readmissions: Potential Measurements Avoid Readmissions Through Collaboration October 27, 2010 Denise Remus, PhD, RN Chief Quality Officer BayCare Health System Overview Why Focus on Readmissions?
More informationMoving the Dial on Quality
Moving the Dial on Quality Washington State Medical Oncology Society November 1, 2013 Nancy L. Fisher, MD, MPH CMO, Region X Centers for Medicare and Medicaid Serving Alaska, Idaho, Oregon, Washington
More information3/19/2013. Medicare Spending Per Beneficiary: The New Link Between Acute and Post Acute Providers
The New Link Between Acute and Post Acute Providers Carol Quiring, RN President and CEO, Home Care and Hospice Saint Luke s Health System Shauna Thompson, RHIT Senior Director, Quality & Patient Safety
More informationFY 2014 Inpatient Prospective Payment System Proposed Rule
FY 2014 Inpatient Prospective Payment System Proposed Rule Summary of Provisions Potentially Impacting EPs On April 26, 2013, the Centers for Medicare and Medicaid Services (CMS) released its Fiscal Year
More informationHospital Inpatient Quality Reporting (IQR) Program
Hospital IQR and VBP Programs: Reviewing Your Claims-Based Measures Hospital-Specific Reports Questions and Answers Speakers Tamara Mohammed, MHA, PMP Measure Implementation and Stakeholder Communication
More informationMedicare Inpatient Psychiatric Facility Prospective Payment System
Medicare Inpatient Psychiatric Facility Prospective Payment System Payment Rule Brief PROPOSED RULE Program Year: FFY 2016 Overview and Resources On April 24, 2015, the Centers for Medicare and Medicaid
More informationFiscal Year 2014 Final Rule: Updates for LTCHs
Fiscal Year 2014 Final Rule: Updates for LTCHs Kristen Smith, MHA, PT Senior Consultant, Fleming-AOD Mary Dalrymple Managing Director, LTRAX FY14 Final Rule & Impact Objectives Review updates to the FY14
More informationNew Models in Payment: Joint Replacements. Sharon Eloranta, MD February 18, 2016
New Models in Payment: Joint Replacements Sharon Eloranta, MD February 18, 2016 Qualis Health A leading national population health management organization The Medicare Quality Innovation Network - Quality
More informationSkilled Nursing Facility Quality Reporting Program Coding Section GG
Judy Wilhide Brandt, RN, BA, RAC-MT, QCP, CPC, DNS-CT judy@judywilhide.com 909-800-9124 www.judywilhide.com Skilled Nursing Facility Quality Reporting Program Coding Section GG January 2018 NC & VA Source
More informationBundled Payment Primer
Bundled Payment Primer CMS Opened Application February 14, 2014 Why this matters to you! Bundling is a New Business Model Bundling is a focused opportunity to manage risk and achieve gain Control of a
More informationFY2018 Proposed Rule: Payment and Quality Reporting
FY2018 Proposed Rule: Payment and Quality Reporting Mary Dalrymple Managing Director, LTRAX Objectives Describe effects of reimbursement updates Look at new short stay payment system Touch on miscellaneous
More informationUniform Data System. June 22, The Functional Assessment Specialists
The Functional Assessment Specialists June 22, 2017 Seema Verma Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-1671-P P.O. Box 8016 Baltimore,
More informationUnderstanding Hospital Value-Based Purchasing
VBP Understanding Hospital Value-Based Purchasing Updated 12/2017 Starting in October 2012, Medicare began rewarding hospitals that provide high-quality care for their patients through the new Hospital
More informationThe Future of Healthcare Delivery; Are we ready?
The Future of Healthcare Delivery; Are we ready? Lisa K. Saladin, PT, PhD, FAPTA Dean and Professor Medical University of South Carolina copyright LisaSaladin 2016 Objectives 1. Discuss 5 of the projected
More informationPayer s Perspective on Clinical Pathways and Value-based Care
Payer s Perspective on Clinical Pathways and Value-based Care Faculty Stephen Perkins, MD Chief Medical Officer Commercial & Medicare Services UPMC Health Plan Pittsburgh, Pennsylvania perkinss@upmc.edu
More informationNew Quality Measures Will Soon Impact Nursing Home Compare and the 5-Star Rating System: What providers need to know
New Quality Measures Will Soon Impact Nursing Home Compare and the 5-Star Rating System: What providers need to know Presented by: Kathy Pellatt, Senior Quality Improvement Analyst LeadingAge New York
More informationAlternative Payment Models and Health IT
Alternative Payment Models and Health IT Health DataPalooza Preconference May 8, 2016 Kelly Cronin, MS, MPH, Director, Office of Care Transformation, ONC/HHS HHS Goals for Medicare Payment Reform In January
More informationTransitioning to the New IRF-PAI
Transitioning to the New IRF-PAI 2014. FIM, UDS-PROi, UDSMR, and the UDSMR logo are trademarks of, a division of UB Foundation Activities, Inc. Agenda August 2014 final rule summary Discuss IRF PPS changes
More informationBundled Payments to Align Providers and Increase Value to Patients
Bundled Payments to Align Providers and Increase Value to Patients Stephanie Calcasola, MSN, RN-BC Director of Quality and Medical Management Baystate Health Baystate Medical Center Baystate Health Is
More informationInpatient Quality Reporting Program
Hospital Value-Based Purchasing Program: Overview of FY 2017 Questions & Answers Moderator: Deb Price, PhD, MEd Educational Coordinator, Inpatient Program SC, HSAG Speaker(s): Bethany Wheeler, BS HVBP
More informationHACs, Readmissions and VBP: Hospital Strategies for Turning Lemons into Lemonade
HACs, Readmissions and VBP: Hospital Strategies for Turning Lemons into Lemonade Jennifer Faerberg AAMCFMOLHS Jolee Bollinger Andy Ruskin Morgan Lewis 1 Value Based Purchasing Transforming Medicare from
More informationThe Challenges and Opportunities in Using Data Bundled Payment, Care Improvement
The Challenges and Opportunities in Using Data Bundled Payment, Care Improvement Helen Macfie, Pharm.D., FABC For IHI Leading Population Heath Transformation February, 2017 It started with a project PHYSICIAN
More informationIs HIT a Real Tool for The Success of a Value-Based Program?
Is HIT a Real Tool for The Success of a Value-Based Program? Sally Montes, MPH, RHIA, CCHP President, SM & Associates, Inc. smontes@sm-asociados.com (787) 306-1149 President, PR HFMA Chapter INTRODUCTION
More informationComparison of Bundled Payment Models. Model 1 Model 2 Model 3 Model 4. hospitals, physicians, and post-acute care where
Comparison of Bundled Payment Models General Description Eligible awardees Retrospective bundled Retrospective bundled payment models for payment models for hospitals, physicians, and post-acute care where
More informationSNF QUALITY REPORTING PROGRAM
13 SNF QUALITY REPORTING PROGRAM GENERAL INFORMATION... 3 SNF REVIEW AND CORRECT REPORT... 5 05/2017 v1.00 Certification And Survey Provider Enhanced Reports SNF QRP 13-1 NOTE: Unless otherwise noted,
More informationSwapping, Kickbacks, Fair Market Value: Risks for a Post-Acute Provider
Swapping, Kickbacks, Fair Market Value: Risks for a Post-Acute Provider Alan Schabes, Partner Benesch, Friedlander, Coplan & Aronoff LLP Shannon Drake, VP, Associate General Counsel Kindred at Home Amanda
More informationCommunity Performance Report
: Wenatchee Current Year: Q1 217 through Q4 217 Qualis Health Communities for Safer Transitions of Care Performance Report : Wenatchee Includes Data Through: Q4 217 Report Created: May 3, 218 Purpose of
More informationAccountable Care and the Laboratory Value Proposition. Les Duncan Director of Operations Highmark Health - Home and Community Services
Accountable Care and the Laboratory Value Proposition Les Duncan Director of Operations Highmark Health - Home and Community Services Agenda The Goals and Status of Delivery System Reform and Alternative
More informationQuality Measurement at the Interface of Health Care and Population Health
1 Institute of Medicine Committee on Quality Measures Healthy People Leading Health Indicators December 10, 2012 Quality Measurement at the Interface of Health Care and Population Health Shari M. Ling,
More informationHot Off the Press! The FY2017 Final Rule & Its Implications for Hospices. Presenter. Objectives 08/31/16
Hot Off the Press! The FY2017 Final Rule & Its Implications for Hospices August 31, 2016 Presenter Annette Kiser, MSN, RN, NE-BC Director of Quality & Compliance The Carolinas Center akiser@cchospice.org
More informationReducing Readmissions One-caseat-a-time Using Midas+ Community Case Management
Reducing Readmissions One-caseat-a-time Using Midas+ Community Case Management John Playford, Senior Midas+ Solutions Advisor Barb Craig, Midas+ SaaS Advisor The Problem Historically, up to 25% of patients
More informationMedicare Value Based Purchasing August 14, 2012
Medicare Value Based Purchasing August 14, 2012 Wes Champion Senior Vice President Premier Performance Partners Copyright 2012 PREMIER INC, ALL RIGHTS RESERVED Premier is the nation s largest healthcare
More informationMedicare Quality Based Payment Reform (QBPR) Program Reference Guide Fiscal Years
julian.coomes@flhosp.orgjulian.coomes@flhosp.org Medicare Quality Based Payment Reform (QBPR) Program Reference Guide Fiscal Years 2018-2020 October 2017 Table of Contents Value Based Purchasing (VBP)
More informationThe 5 W s of the CMS Core Quality Process and Outcome Measures
The 5 W s of the CMS Core Quality Process and Outcome Measures Understanding the process and the expectations Developed by Kathy Wonderly RN,BSPA, CPHQ Performance Improvement Coordinator Developed : September
More information