Impact of a Discharge Concierge Medication Delivery Service on Patient Satisfaction Scores

Transcription

1 Impact of a Discharge Concierge Medication Delivery Service on Patient Satisfaction Scores Katie Clark McKinney, PharmD, MS, BCPS, FACHE, FASHP Director, Pharmacy Services UC Health University of Cincinnati Medical Center Cincinnati, OH

2 Learning Objectives Describe the impact of Value-Based Purchasing and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey on hospital reimbursement List the questions included in the "Communication About Medications" dimension of the HCAHPS survey Describe the impact of the Discharge Concierge Medication Delivery Service in patient scoring of the Communication About Medications dimension of the HCAHPS survey 2

3 Self-Assessment Questions 1. True or False: Participation in Value-Based Purchasing and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is optional 2. The questions included in the "Communication About Medications" dimension of the HCAHPS survey inquire as to if: A. Patient took a new medication during his/her hospital stay B. Patient was educated regarding what the medication was for prior to taking the first dose C. Patient was educated regarding the side effects of the medication prior to taking the first dose D. All of the above 3. True or False: Participation in the discharge concierge medication delivery service demonstrates statistically significant improvement in patient scoring of the Communication About Medications dimension of the HCAHPS survey as compared to patients that did not use this service 3

4 Overview The Affordable Care Act resulted in changes to patient access and health-system reimbursement - Health-system: Patient options to select pharmacy with prescription benefit - Value-Based Purchasing - Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) 4

5 History of Medicare Reimbursement Fee-for- Service Increased: Number of services per patient Revenue for hospital Costs on healthcare system Length of Stay Decreased: Quality of care Diagnosis Related Group Fixed, prospective payment for services Decreased: Length of Stay Healthcare system expense Quality of care Value-Based Purchasing Greater reimbursement for services that are of higher value Withholding of reimbursement for services of low quality Wolters Kluwer. (2017). Value Based Purchasing Regulations and Other Primary Source. Retrieved from web on 4/1/17

6 Value-Based Purchasing Value-Based Purchasing (VBP) refers to payment for care that rewards better value - Quality incentive program - Reduced reimbursement for under-performing hospitals - Potential for high reimbursement for top-performing hospitals - Performance is defined by CMS 6

7 History of Medicare Reimbursement Medicare Modernization Act Mandated creation of the Hospital Inpatient Quality Reporting Program (H-IQR) Hospitalcompare.gov Participation Not required initially Affordable Care Act Required CMS establish a hospital- VBP program Incentive payments are built on the H-IQR measure infrastructure Quality of patient care is assessed by domains of care Value-Based Purchasing 4 quality domains: Clinical Care Patient Experience of Care Safety Efficiency Wolters Kluwer. (2017). Value Based Purchasing Regulations and Other Primary Source. Retrieved from web on 4/1/17

8 VBP Payment The VBP program is entirely self-funded and budget neutral Medicare withholds a percentage of the usual Diagnosis-Related Group (DRG) payments that a hospital would receive for treating a given patient with a particular disease state FY 2015: 1.5% FY 2016: 1.75% FY 2017: 2% FY 2018: 2% All hospitals in the nation compete against each other, on the basis of quality, for a redistribution of the dollars that have been withheld 8

9 Quality Domains Fiscal Year 2018 Clinical Care Patient Experience of Care Safety Efficiency / Cost Reduction 9

10 UCMC Retail Pharmacy Services 10

11 UCMC Retail Pharmacy Services Two 340B eligible (closed-door) retail pharmacies: Hoxworth Pharmacy 650 prescriptions per day Holmes Pharmacy 150 prescriptions per day 11

12 UCMC Retail Pharmacy Services Two 340B eligible (closed-door) retail pharmacies: Hoxworth Pharmacy 650 prescriptions per day Holmes Pharmacy 150 prescriptions per day Challenge: Regain prescription fill volume in a scarcity market condition 12

13 Discharge Concierge Medication Delivery Service ered+rollout+schedule&gs_l=psy-ab c.1.64.psy-ab i24k MXA8U4y5I#imgrc=2mgQRf84RR1xCM:

14 Services Provided g+medications&oq=delivery+walking+medications&gs_l=psyab j c.1.64.psyab i8i30k1.0.bep78dzwtme#imgrc=uqut79k8cwz7tm: 14

15 Patient and Provider Experience 15

16 Patient Satisfaction 16

17 HCAHPS Communication About Medications

18 HCAHPS Top-Box Percentage FY17Q4 Communication About Medications Dimension 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Comm Re: Meds Domain Score: Staff describe medicine side effect Tell you what new medicine was for Understood purpose of taking medications at discharge Concierge Counseling Provided n=233 Concierge Counseling NOT Provided n=397

19 HCAHPS Top-Box Percentage FY17 Total Communication About Medications Dimension 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Comm Re: Meds Domain Score: Staff describe medicine side effect Tell you what new medicine was for Understood purpose of taking medications at discharge Concierge Counseling Provided n=635 Concierge Counseling NOT Provided n=1318

20 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% HCAHPS Top-Box % July 2017 (FY18) Communication About Medications Dimension HCAHPS Topbox% July % Staff describe medicine side effect Tell you what new medicine was for Understood purpose of taking medications Concierge Patients n=38 Non-Concierge Patients n=155

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22 Discharge Concierge Medication Delivery Service Strengths: Multidisciplinary collaboration Improves transitions of care and patient access Allows strategy in managing threats Opportunities: Same Day Surgery/Post-Anesthesia Care Unit Emergency Department Hospital-based clinics Hours of service Ability to quantify contribution to VBP repayment

23 Questions? Katie Clark McKinney, PharmD, MS, BCPS, FACHE, FASHP Director, Pharmacy Services UC Health University of Cincinnati Medical Center, Cincinnati OH 23