Outline. Background. Public Reporting & Pay for Performance in Hospital Quality Improvement
|
|
- Hortense Dean
- 5 years ago
- Views:
Transcription
1 Public Reporting & Pay for Performance in Hospital Quality Improvement Peter Lindenauer MD MSc Associate Professor of Medicine Tufts University School of Medicine Outline Review forces driving PR and P4P Highlight inpatient PR and P4P programs Examine evidence for benefit Background Public reporting and pay for performance programs are proliferating in the US and worldwide Hospitals Nursing home Ambulatory care Federal mandate is accelerating process Deficit Reduction Act (2005) required CMS to develop plan for Value Based Purchasing (P4P) by
2 Still controversial after all these years c.1860 Florence Nightingale Mortality rates at London hospitals c.1917 Ernest Codman Surgical outcomes in Boston c.1990 NY CABG Report Cards c Hospital Quality Alliance Driving Forces National imperatives Improve quality and safety faster Reduce costs Cultural changes Increasing consumerism Information technology Ubiquity of personal computers Internet / World Wide Web How do you choose a tire? 2
3 Benefits of Public Reporting Improves transparency of health system Empowers patients to make better choices Strengthens the business case for quality Stimulates interest among clinicians, administrators, trustees in quality of care Hospital Quality Alliance (HQA) Public-private collaboration begun in 2002 AHA, AAMC, FAH, CMS All hospitals invited to particpate Participation linked to Medicare s annual payment update. P4R To invigorate efforts to improve quality Initially 10 measures over 3 conditions AMI, HF, Pneumonia Has expanded annually; now >20 measures Available on Hospital Compare website 3
4 Hospital Public Reporting P4R 0.4% Incentive August, 2003 February, 2004 May, 2004 October, 2004 March, 2005 Number of Reporting Hospitals 98.3% of PPS hospitals now reporting Hospitals, if they wish to be sure of improvement, must find out what their results are, must analyze their results, and must compare their results with those of other hospitals. Ernest Codman
5 How much do the patients care? The information age A world of options 5
6 A well educated patient will choose the best Craig Smith Chief CT Surgery Columbia s Risk Adjusted Mortality was ~ 2X the NY State average 6
7 Why would Bill Clinton go to the worst CABG hospital in New York? Anyone can have a bad year. Clinton understood this and was willing to give them another shot. Clinton knew that the risk adjustment model didn t adequately account for the complexity and severity of cases at Columbia Like other New Yorkers he didn t base his choice on report cards / publicly reported data Proximity, word of mouth, and established referral patterns more powerful determinants of where we obtain care. Pay for Performance Rewards excellence directly Not reliant on behavior of patients Strengthens the business case for quality Reverses perverse financial incentives Additional payments received by hospitals following complications; regardless of their preventability >100 pay for performance initiatives being sponsored nationwide 7
8 CMS / Premier Hospital Quality Incentive Demonstration (HQID) To determine if economic incentives are effective at improving the quality of inpatient care 1-2% year end bonus payment to hospitals in the top 2 deciles of performance on composite measure Average 71k; Range 1-875k 33 Measures across 5 Conditions AMI, HF, Pneumonia, CABG, TJR 266 (63%) hospitals agreed to participate An important question Given the widespread use of public reporting, how much benefit will be gained from the addition of financial incentives.very impressive gains 8
9 So, how much benefit, really? Methods Matched each HQID participant with similar hospitals from larger HQA universe* Size, Teaching Status, Location, etc Excluded Perspective hospitals that had declined to participate from the control group Calculated 2 year absolute improvement % for individual and composite quality measures Calculated the difference in improvement at P4P and PR hospitals. 9
10 Contribution from other factors Stratified analyses evaluated impact of Teaching status Bed size Baseline performance Adjusted Outcomes Multiple linear regression applied to the matched sample to control for differences in baseline performance of the two groups of hospitals Analyses repeated using entire pool of HQA hospitals without matching In additional analysis based on the intent to treat concept we attempted to control for volunteer bias among P4P hospitals by including decliners and withdrawers in the P4P group 10
11 Limitations Did not have a control group not exposed to either P4P or PR Only able to describe the incremental benefit of P4P when combined with PR. Not the benefit of PR or of P4P Our analysis limited to 10 of the 33 measures included in the HQID Cannot comment on CABG, TJR Did not assess improvement in outcomes 11
12 Is the P4P glass half full or half empty? January 25th 2007 January 26th 2007 Explanations for limited impact Public reporting sufficient motivator Small marginal benefit from P4P Financial incentives too small 1-2% bonus small by exec pay standards High baseline performance on measures 7 of 10 measures had rates ~ 90% Maximum absolute % improvements were small Approach to representing improvement may have minimized effect Alternative - relative reduction in failure (akin to clinical trials) Sobering words If we are going to put very strong incentives on quality measures, let s make really sure that we know this measure will improve outcomes. Right now, we don t have enough validated measures. In that sense, I don t think we are ready for a national (pay-for-performance) system, Mark Chassin, President Joint Commission 12
Value based Purchasing Legislation, Methodology, and Challenges
Value based Purchasing Legislation, Methodology, and Challenges Maryland Association for Healthcare Quality Fall Education Conference 29 October 2009 Nikolas Matthes, MD, PhD, MPH, MSc Vice President for
More informationLinking Supply Chain, Patient Safety and Clinical Outcomes
Premier s Vision for High Performing Healthcare Organizations: Linking Supply Chain, Patient Safety and Clinical Outcomes Joe M. Pleasant Sr. VP and CIO Premier Inc. Global GS1 Conference Hong Kong October
More informationPay-for-performance experiments in health care. Mattias Lundberg, World Bank SIEF Regional Impact Evaluation Workshop Sarajevo, Bosnia September 2009
Pay-for-performance experiments in health care Mattias Lundberg, World Bank SIEF Regional Impact Evaluation Workshop Sarajevo, Bosnia September 2009 Outline Background What s the problem? Agency and information
More informationPay-for-Performance. GNYHA Engineering Quality Improvement
Pay-for-Performance GNYHA Engineering Quality Improvement The Writing Is On The Wall IOM Report - Rewarding Provider Performance: Aligning Incentives In Medicare 9/21/06 Medicare P4P and quality improvement
More informationCMS Quality Initiatives: Past, Present, and Future
CMS Quality Initiatives: Past, Present, and Future Jeff Flick Regional Administrator CMS, Region IX June 29, 2007 Slide -1 Learning Objectives Value Driven Health Care CMS Quality Initiatives Premiere
More informationPublic Reporting and Pay for Performance in Hospital Quality Improvement
T h e n e w e ng l a nd j o u r na l o f m e dic i n e special article Public Reporting and Pay for Performance in Hospital Quality Improvement Peter K. Lindenauer, M.D., M.Sc., Denise Remus, Ph.D., R.N.,
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 informationImproving Healthcare Quality through Standardization and Innovation
Improving Healthcare Quality through Standardization and Innovation Presented by P. Jon White, MD Health IT Portfolio Manager Agency for Healthcare Research and Quality Building a Transparent Health Care
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 informationMedicare Value-Based Purchasing for Hospitals: A New Era in Payment
Medicare Value-Based Purchasing for Hospitals: A New Era in Payment Daniel J. Hettich March, 2012 I. Introduction: Evolution of Medicare as a Purchaser Cost reimbursement rewards furnishing more services
More informationP4P Programs 9/13/2013. Medicare P4P Programs. Medicaid P4P Programs
P4P Programs Medicare P4P Programs Hospital Quality Reporting Programs (IQR and OQR) Hospital Value-Based Purchasing (VBP) Program Hospital Readmissions Reduction Program (HRRP) Hospital-Acquired Conditions
More informationMarket Mover? The Emerging Role of CMS in P4P. Linda Magno Director, Medicare Demonstrations Group August 24, 2004
Market Mover? The Emerging Role of CMS in P4P Linda Magno Director, Medicare Demonstrations Group August 24, 2004 Why Medicare P4P? Quality & Patient Safety Significant room for improvement Significant
More informationAn Investigation into CMS's Value-Based Purchasing Proposal
An Investigation into CMS's Value-Based Purchasing Proposal By Jake Ing '--- L A Master's Paper submitted to the faculty of the University of North Carolina at Chapel Hill in the partial fulfillment of
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 informationJuly 2, 2010 Hospital Compare: New ED and Outpatient. Information; Annual Update to Readmission and Mortality Rates
July 2, 2010 Hospital Compare: New ED and Outpatient Information; Annual Update to Readmission and Mortality Rates AT A GLANCE The Issue: In early July, information on care provided in the hospital outpatient
More informationHospital Value-Based Purchasing (VBP) Program
Hospital Value-Based Purchasing (VBP) Program: Overview of the Fiscal Year 2020 Baseline Measures Report Presentation Transcript Moderator Gugliuzza, MBA Project Manager, Hospital VBP Program Hospital
More informationValue-Based Purchasing & Payment Reform How Will It Affect You?
Value-Based Purchasing & Payment Reform How Will It Affect You? HFAP Webinar September 21, 2012 Nell Buhlman, MBA VP, Product Strategy Click to view recording. Agenda Payment Reform Landscape Current &
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 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 informationPATH Program. Getting Started Guide
PATH Program Getting Started Guide We have a BIG opportunity. Together, we can empower and encourage people to take an active role in their health. Preventive health care services help people find and
More informationHow to Win Under Bundled Payments
How to Win Under Bundled Payments Donald E. Fry, M.D., F.A.C.S. Executive Vice-President, Clinical Outcomes MPA Healthcare Solutions Chicago, Illinois Adjunct Professor of Surgery Northwestern University
More informationFuture of Quality Reporting and the CMS Quality Incentive Programs
Future of Quality Reporting and the CMS Quality Incentive Programs Current Quality Environment Continued expansion of quality evaluation Increasing Reporting Requirements Increased Public Surveillance/Scrutiny
More informationDesigning Quality into an EMR/CPOE Implementation. Kristine Martin Anderson
Designing Quality into an EMR/CPOE Implementation Kristine Martin Anderson 1 Healthcare Industry Movements Impacting Hospitals Pay for Performance brings employers, purchasers and providers together to
More informationHospital Compare Quality Measures: 2008 National and Florida Results for Critical Access Hospitals
Hospital Compare Quality Measures: National and Results for Critical Access Hospitals Michelle Casey, MS, Michele Burlew, MS, Ira Moscovice, PhD University of Minnesota Rural Health Research Center Introduction
More informationCMS DATA FOR THE PUBLIC What We Intend To Do About It! Stephen Sibbitt, MD, FACP Chief Medical Officer Scott & White Memorial Hospital
CMS DATA FOR THE PUBLIC What We Intend To Do About It! Stephen Sibbitt, MD, FACP Chief Medical Officer Scott & White Memorial Hospital What does this metric suggest to you? Good Performance? Great Performance?
More informationGlobal Budget Revenue. October 8, 2015
Global Budget Revenue October 8, 2015 Goals Understand GBR s connection to the goals of Maryland s Demonstration Understand impact on budgeting and planning for RFP and future phases Answer questions that
More informationCENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) / PREMIER HOSPITAL QUALITY INCENTIVE DEMONSTRATION PROJECT
CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) / PREMIER HOSPITAL QUALITY INCENTIVE DEMONSTRATION PROJECT Project Overview and Findings from Year One APRIL 13, 2006 Table of Contents EXECUTIVE SUMMARY...
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 informationProgram Summary. Understanding the Fiscal Year 2019 Hospital Value-Based Purchasing Program. Page 1 of 8 July Overview
Overview This program summary highlights the major elements of the fiscal year (FY) 2019 Hospital Value-Based Purchasing (VBP) Program administered by the Centers for Medicare & Medicaid Services (CMS).
More informationPaying for Outcomes not Performance
Paying for Outcomes not Performance 1 3M. All Rights Reserved. Norbert Goldfield, M.D. Medical Director 3M Health Information Systems, Inc. #Health Information Systems- Clinical Research Group Created
More informationThe Alternative Quality Contract (AQC): Improving Quality While Slowing Spending Growth
The Alternative Quality Contract (AQC): Improving Quality While Slowing Spending Growth Dana Gelb Safran, ScD Senior Vice President, Performance Measurement and Improvement Presented at: MAHQ 16 April
More information1.01 Government Programs: CMS and Pay for Performance: Current Issues. CMS Regional Administrator March 2009
1.01 Government Programs: CMS and Pay for Performance: Current Issues David Saÿen CMS Regional Administrator March 2009 Overview Why value-based purchasing? What demonstrations are underway? Hospital demonstrations
More informationScoring Methodology FALL 2017
Scoring Methodology FALL 2017 CONTENTS What is the Hospital Safety Grade?... 4 Eligible Hospitals... 4 Measures... 5 Measure Descriptions... 9 Process/Structural Measures... 9 Computerized Physician Order
More informationThe Potential Impact of Pay-for-Performance on the Financial Health of Critical Access Hospitals
Flex Monitoring Team Briefing Paper No. 23 The Potential Impact of Pay-for-Performance on the Financial Health of Critical Access Hospitals December 2009 The Flex Monitoring Team is a consortium of the
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 informationCAHPS Focus on Improvement The Changing Landscape of Health Care. Ann H. Corba Patient Experience Advisor Press Ganey Associates
CAHPS Focus on Improvement The Changing Landscape of Health Care Ann H. Corba Patient Experience Advisor Press Ganey Associates How we will spend our time together Current CAHPS Surveys New CAHPS Surveys
More informationPerformance Payment: Never Pay for Never Events: Including Readmissions in Medicare s s (non-payment for) Hospital Acquired Conditions Policy
Performance Payment: Never Pay for Never Events: Including Readmissions in Medicare s s (non-payment for) Hospital Acquired Conditions Policy Peter McNair and Hal Luft Palo Alto Medical Foundation Research
More informationMeasuring the Quality of Outcomes in Healthcare using HIPE data
Measuring the Quality of Outcomes in Healthcare using HIPE data Brendan Kennelly Health Economics and Policy Analysis Centre Cairnes School of Business and Economics NUI Galway Overview Why focus on quality?
More informationCOPD & Pneumonia Readmission Reduction Program. October 25, 2017
COPD & Pneumonia Readmission Reduction Program October 25, 2017 Susan J. Bowers, MBA, BSN, RN Chief Quality Officer Mercy Health - Lorain 2 Locations Mercy Health Lorain Hospital Lorain, Ohio 250 bed community
More informationNational Provider Call: Hospital Value-Based Purchasing
National Provider Call: Hospital Value-Based Purchasing Fiscal Year 2015 Overview for Beneficiaries, Providers, and Stakeholders Centers for Medicare & Medicaid Services 1 March 14, 2013 Medicare Learning
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 informationAligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model. Rome H. Walker MD February 28, 2008
Aligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model Rome H. Walker MD February 28, 2008 A Concerted Effort Because the rewards are based on shared performance, the program is intended to create
More informationHOSPITAL QUALITY MEASURES. Overview of QM s
HOSPITAL QUALITY MEASURES Overview of QM s QUALITY MEASURES FOR HOSPITALS The overall rating defined by Hospital Compare summarizes up to 57 quality measures reflecting common conditions that hospitals
More informationHCAHPS, HSOPS, HACs and HIQRP Connecting the Dots
HCAHPS, HSOPS, HACs and HIQRP Connecting the Dots Sharon Burnett, R.N., BSN, MBA Vice President of Clinical and Regulatory Affairs Missouri Hospital Association Objectives Discuss how the results of the
More informationPerformance Scorecard 2013
NORTHWESTERN LAKE FOREST HOSPITAL Performance Scorecard 2013 updated May 2013 Northwestern Lake Forest Hospital is committed to providing the communities we serve the highest quality health care through
More informationSurgical Care for the Underserved: US We have our own problems
Surgical Care for the Underserved: US We have our own problems Gregg Marshall Grand Rounds February 27, 2012 Outline Introduction US Statistics Underserved populations in the US Global Health Lack of infrastructure
More informationMedicare Value Based Purchasing Overview
Medicare Value Based Purchasing Overview Washington State Hospital Association Apprise Health Insights / Oregon Association of Hospitals and Health Systems DataGen Susan McDonough Lauren Davis Bill Shyne
More informationScoring Methodology SPRING 2018
Scoring Methodology SPRING 2018 CONTENTS What is the Hospital Safety Grade?... 4 Eligible Hospitals... 4 Measures... 6 Measure Descriptions... 9 Process/Structural Measures... 9 Computerized Physician
More informationFuture Proofing Healthcare: Who Knows?
Future Proofing Healthcare: Who Knows? Marcel Loh Chief Executive, Swedish Suburban Hospitals & Affiliates Swedish Health Services 2 3 4 Things do not happen. Things are made to happen. John F. Kennedy
More information5/26/2015. January 26, 2015 INCENTIVES AND PENALTIES. Medicare Readmission Penalties. CMS Bundled Payment Providers & ACOs in NE
Agenda ESTABLISHING SHARED EXPECTATIONS New tool of ACOs, Bundled Payments & Readmission Reduction Update on current market pressures driving a focus on care across settings & over time at lowest cost
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 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 informationRE: Medicare Program; Request for Information Regarding the Physician Self-Referral Law
1055 N. Fairfax Street, Suite 204, Alexandria, VA 22314, TEL (703) 299-2410, (800) 517-1167 FAX (703) 299-2411 WEBSITE www.ppsapta.org August 24, 2018 Seema Verma, MPH Administrator Centers for Medicare
More informationQuality and Health Care Reform: How Do We Proceed?
Quality and Health Care Reform: How Do We Proceed? Susan D. Moffatt-Bruce, MD, PhD Chief Quality and Patient Safety Officer Associate Dean of Clinical Affairs Quality and Patient Safety Associate Professor
More informationNORTHWESTERN LAKE FOREST HOSPITAL. Scorecard updated September 2012
NORTHWESTERN LAKE FOREST HOSPITAL Performance Scorecard 2012 updated September 2012 Northwestern Lake Forest Hospital is committed to providing the communities we serve the highest quality healthcare through
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 informationSIMPLE SOLUTIONS. BIG IMPACT.
SIMPLE SOLUTIONS. BIG IMPACT. SIMPLE SOLUTIONS. BIG IMPACT. QUALITY IMPROVEMENT FOR INSTITUTIONS combines the American College of Cardiology s (ACC) proven quality improvement service solutions and its
More informationHealthcare Reform Hospital Perspective
Healthcare Reform Hospital Perspective Susan DeVore President and CEO, Premier, Inc. March 8, 2010 1 The end of an illusion 2 Current landscape for healthcare reform 3 Specific policies require a paradigm
More informationThe dawn of hospital pay for quality has arrived. Hospitals have been reporting
Value-based purchasing SCIP measures to weigh in Medicare pay starting in 2013 The dawn of hospital pay for quality has arrived. Hospitals have been reporting Surgical Care Improvement Project (SCIP) measures
More informationpaymentbasics The IPPS payment rates are intended to cover the costs that reasonably efficient providers would incur in furnishing highquality
Hospital ACUTE inpatient services system basics Revised: October 2015 This document does not reflect proposed legislation or regulatory actions. 425 I Street, NW Suite 701 Washington, DC 20001 ph: 202-220-3700
More informationCare Redesign: An Essential Feature of Bundled Payment
Issue Brief No. 11 September 2013 Care Redesign: An Essential Feature of Bundled Payment Jett Stansbury Director, New Payment Strategies, Integrated Healthcare Association Gabrielle White, RN, CASC Executive
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 information2017/2018. KPN Health, Inc. Quality Payment Program Solutions Guide. KPN Health, Inc. A CMS Qualified Clinical Data Registry (QCDR) KPN Health, Inc.
2017/2018 KPN Health, Inc. Quality Payment Program Solutions Guide KPN Health, Inc. A CMS Qualified Clinical Data Registry (QCDR) KPN Health, Inc. 214-591-6990 info@kpnhealth.com www.kpnhealth.com 2017/2018
More informationHow Allina Saved $13 Million By Optimizing Length of Stay
Success Story How Allina Saved $13 Million By Optimizing Length of Stay EXECUTIVE SUMMARY Like most large healthcare systems throughout the country, Allina Health s financial health improves dramatically
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 informationThe Long-Term Effect of Premier Pay for Performance on Patient Outcomes
T h e n e w e ngl a nd j o u r na l o f m e dic i n e Special article The Long-Term Effect of Premier Pay for Performance on Patient Outcomes Ashish K. Jha, M.D., M.P.H., Karen E. Joynt, M.D., M.P.H.,
More informationThe Reality of Health Care Reform: Accountable Care, Bundled Payments and Opportunities for Innovation
The Reality of Health Care Reform: Accountable Care, Bundled Payments and Opportunities for Innovation May 11, 2010 Douglas A. Hastings Chair, Epstein Becker & Green, P.C. Member, Board on Health Care
More informationInnovation and Diagnosis Related Groups (DRGs)
Innovation and Diagnosis Related Groups (DRGs) Kenneth R. White, PhD, FACHE Professor of Health Administration Department of Health Administration Virginia Commonwealth University Richmond, Virginia 23298
More informationHealthcare Reimbursement Change VBP -The Future is Now
Healthcare Reimbursement Change VBP -The Future is Now 1 On the Move Volume/ Fee-for-Service Fee-for-service reimbursement High quality not rewarded No shared financial risk Stand-alone systems can thrive
More informationDisclosures. Platforms for Performance: Clinical Dashboards to Improve Quality and Safety. Learning Objectives
Platforms for Performance: Clinical Dashboards to Improve Quality and Safety Disclosures The program chair and presenters for this continuing pharmacy education activity report no relevant financial relationships.
More informationMedicare Value Based Purchasing Overview
Medicare Value Based Purchasing Overview South Carolina Hospital Association DataGen Susan McDonough Bill Shyne October 29, 2015 Today s Objectives Overview of Medicare Value Based Purchasing Program Review
More informationSCORING METHODOLOGY APRIL 2014
SCORING METHODOLOGY APRIL 2014 HOSPITAL SAFETY SCORE Contents What is the Hospital Safety Score?... 4 Who is The Leapfrog Group?... 4 Eligible and Excluded Hospitals... 4 Scoring Methodology... 5 Measures...
More information75,000 Approxiamte amount of deaths ,000 Number of patients who contract HAIs each year 1. HAIs: Costing Everyone Too Much
HAIs: Costing Everyone Too Much July 2015 Healthcare-associated infections (HAIs) are serious, sometimes fatal conditions that have challenged healthcare institutions for decades. They are also largely
More informationValue, Suffering, and 10 Things I Didn t Know Before My New Job
Value, Suffering, and 10 Things I Didn t Know Before My New Job Thomas H. Lee, MD October 28, 2013 2 1 Why We Are Stuck 3 Getting Unstuck 2 Step One: Clarifying the Overarching Goal In the absence of an
More informationQualityPath Cardiac Bypass (CABG) Maintenance of Designation
QualityPath Cardiac Bypass (CABG) Maintenance of Designation Introduction 1. Overview of The Alliance The Alliance moves health care forward by controlling costs, improving quality, and engaging individuals
More informationHealth Care Systems - A National Perspective Erica Preston-Roedder, MSPH PhD
Health Care Systems - A National Perspective Erica Preston-Roedder, MSPH PhD Outline Quality Overview Overview and discussion of CMS programs Increasing transparency Move from P4R to P4P Expanding beyond
More informationAssessing and Optimizing Operations and Patient Flow in VHA Facilities
Assessing and Optimizing Operations and Patient Flow in VHA Facilities A six-month professional development program for VHA leaders and staff PROFESSIONAL DEVELOPMENT PROGRAM Assessing and Optimizing Operations
More informationSpecial Open Door Forum Participation Instructions: Dial: Reference Conference ID#:
Page 1 Centers for Medicare & Medicaid Services Hospital Value-Based Purchasing Program Special Open Door Forum: FY 2013 Program Wednesday, July 27, 2011 1:00 p.m.-3:00 p.m. ET The Centers for Medicare
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 informationAugust 1, 2012 (202) CMS makes changes 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 Contact: CMS Media Relations
More informationImproving Hospital Performance Through Clinical Integration
white paper Improving Hospital Performance Through Clinical Integration Rohit Uppal, MD President of Acute Hospital Medicine, TeamHealth In the typical hospital, most clinical service lines operate as
More informationIncentives and Penalties
Incentives and Penalties CAUTI & Value Based Purchasing and Hospital Associated Conditions Penalties: How Your Hospital s CAUTI Rate Affects Payment Linda R. Greene, RN, MPS,CIC UR Highland Hospital Rochester,
More informationExecutive Summary November 2008
November 2008 Purpose of the Study This study analyzes short-term risks and provides recommendations on longer-term policy opportunities for the Marin County healthcare delivery system in general as well
More informationPerformance Measurement Work Group Meeting 10/18/2017
Performance Measurement Work Group Meeting 10/18/2017 Welcome to New Members QBR RY 2020 DRAFT QBR Policy Components QBR Program RY 2020 Snapshot QBR Consists of 3 Domains: Person and Community Engagement
More informationsnapshot Improving Experience of Care Scores Alone is NOT the Answer: Hospitals Need a Patient-Centric Foundation
SATISFACTION snapshot news, views & ideas from the leader in healthcare satisfaction measurement The Satisfaction Snapshot is a monthly electronic bulletin freely available to all those involved or interested
More informationRural Policy Research Institute Health Panel. CMS Value-Based Purchasing Program and Critical Access Hospitals. January 2009
RUPRI Health Panel Keith J. Mueller, PhD, Chair www.rupri.org/ruralhealth (402) 559-5260 kmueller@unmc.edu Rural Policy Research Institute Health Panel CMS Value-Based Purchasing Program and Critical Access
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 informationCCHS: Quality and Patient Safety. J Michael Henderson, MD Guido Bergomi
CCHS: Quality and Patient Safety J Michael Henderson, MD Guido Bergomi Outline Integrated Quality & Safety structure Quality Goals and Performance Improvement Quality data sources Quality Reporting The
More informationCompleting the Specialty Practice Assessment Tool: Guide for Behavioral Health Organizations and Divisions
Completing the Specialty Practice Assessment Tool: Guide for Behavioral Health Organizations and Divisions Instructions: Please find below guiding questions for behavioral health organizations or divisions
More informationSaint Francis Care and Cigna CAC Meeting the Triple Aim Together
Saint Francis Care and Cigna CAC Meeting the Triple Aim Together Christopher M. Dadlez, President and CEO Saint Francis Care Jess Kupec, President and CEO Saint Francis HealthCare Partners 22 nd Annual
More informationEnterprising leadership is never satisfied with
Hardwired for Excellence A Collaborative solution to linen utilization By Sarah H. James, RLLD bench mark (bĕnch märk ) n. 1. The systematic process of comparing an organization s products, services and
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 informationHospital Strength INDEX Methodology
2017 Hospital Strength INDEX 2017 The Chartis Group, LLC. Table of Contents Research and Analytic Team... 2 Hospital Strength INDEX Summary... 3 Figure 1. Summary... 3 Summary... 4 Hospitals in the Study
More informationHospital/Physician Affiliation Trends. December 6, 2011
Hospital/Physician Affiliation Trends December 6, 2011 Hospital Strategies in 2011 I. Introduction VMG Health ( VMG ) Jim Rolfe Biography Jen Johnson, CFA Biography II. Hospital Market III. Hospital Acquisitions
More informationStandards of Care: Who is Determining How We Practice
Standards of Care: Who is Determining How We Practice Louis H. Diamond, MD 2008 Nephrology Conference March 20, 2008 Solucient Outline Learn about the national quality agenda Describe some of the challenges
More information3. What does Any Willing Provider (AWP) refer to in the context of MLTSS?
Overview of Any Willing Qualified Provider (AWQP) Initiative 1. What is Any Willing Qualified Provider? The Any Willing Qualified Provider (AWQP) is a Department of Human Services (DHS) Nursing Facility
More informationQuality Payment Program MIPS. Advanced APMs. Quality Payment Program
Proposed Rule: Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models The Department
More informationTroubleshooting Audio
Welcome! Audio for this event is available via ReadyTalk Internet Streaming. No telephone line is required. Computer speakers or headphones are necessary to listen to streaming audio. Limited dial-in lines
More informationCMS 30-Day Risk-Standardized Readmission Measures for AMI, HF, Pneumonia, Total Hip and/or Total Knee Replacement, and Hospital-Wide All-Cause Unplanned Readmission 2013 Hospital Inpatient Quality Reporting
More informationScoring Methodology FALL 2016
Scoring Methodology FALL 2016 CONTENTS What is the Hospital Safety Grade?... 4 Eligible Hospitals... 4 Measures... 5 Measure Descriptions... 7 Process/Structural Measures... 7 Computerized Physician Order
More information