CMS in the 21 st Century
|
|
- Tiffany Heath
- 5 years ago
- Views:
Transcription
1 CMS in the 21 st Century ICE 2013 ANNUAL CONFERENCE David Saÿen, MBA Regional Administrator Centers for Medicare & Medicaid Services San Francisco November 15, 2013
2 The strategy is to concurrently pursue three aims
3 Success requires delivery system and payment transformation Volume Driven Outcomes Driven Payment systems support fragmentation Fragmented payment systems (IPPS, OPPS, RBRVS) Fee-for-service payment model Lack of transparency Private Sector + Public Sector + Innovation Center Payment systems support collaboration Value-based purchasing ACOs Episode-based payments Patient-centered Medical Homes Data transparency
4 Value-Based Purchasing Program Objectives over Time Towards Attainment of the Three-Part Aim Initial programs FY Limited to hospitals (HVBP) and dialysis facilities (QIP) Existing measures providers recognize and understand Focus on provider awareness, participation, and engagement Proposed and near-term programs FY Expand to include physicians New measures to address HHS priorities Increasing emphasis on patient experience, cost, and clinical outcomes Increasing provider engagement to drive quality improvements, e.g., learning and action networks Longer-term FY2017+ VBP measures and incentives aligned across multiple settings of care and at various levels of aggregation (individual physician, facility, health system) Measures are patient-centered and outcome oriented Measure set addresses all 6 national priorities well Rapid cycle measure development and implementation Continued support of QI and engagement of clinical community and patients Greater share of payment linked to quality Vision for VBP
5 FY2013 HVBP Program Summary Two domains: Clinical Process of Care (12 measures) Patient Experience of Care (8 HCAHPS dimensions) Hospitals are given points for Achievement and Improvement for each measure or dimension, with the greater set of points used 70% of Total Performance Score based on Clinical Process of Care measures 30% of Total Performance Score based on Patient Experience of Care dimensions Payment adjustments in process
6 13 Clinical Process of Care Measures 1. AMI-7a Fibrinolytic Therapy Received within 30 Minutes of Hospital Arrival 2. AMI-8 Primary PCI Received within 90 Minutes of Hospital Arrival 3. HF-1 Discharge Instructions 4. PN-3b Blood Cultures Performed in the ED Prior to Initial Antibiotic Received in Hospital 5. PN-6 Initial Antibiotic Selection for CAP in Immunocompetent Patient 6. SCIP-Inf-1 Prophylactic Antibiotic Received within One Hour Prior to Surgical Incision 7. SCIP-Inf-2 Prophylactic Antibiotic Selection for Surgical Patients 8. SCIP-Inf-3 Prophylactic Antibiotics Discontinued within 24 Hours After Surgery 9. SCIP-Inf-4 Cardiac Surgery Patients with Controlled 6 a.m. Postoperative Serum Glucose 10. SCIP Inf 9 Postoperative Urinary Catheter Removal on Postoperative Day 1 or SCIP-Card-2 Surgery Patients on a Beta Blocker Prior to Arrival That Received a Beta Blocker During the Perioperative Period 12. SCIP-VTE-1 Surgery Patients with Recommended Venous Thromboembolism Prophylaxis Ordered 13. SCIP-VTE-2 Surgery Patients Who Received Appropriate Venous Thromboembolism Prophylaxis within 24 Hours Domain Weights 8 Patient Experience of Care Dimensions 1. Nurse Communication 2. Doctor Communication 3. Hospital Staff Responsiveness 4. Pain Management 5. Medicine Communication 6. Hospital Cleanliness and Quietness 7. Discharge Information 8. Overall Hospital Rating 3 Mortality Measures 1. MORT-30-AMI Acute Myocardial Infarction (AMI) 30-day mortality rate 2. MORT-30-HF Heart Failure (HF) 30-day mortality rate 3. MORT-30-PN Pneumonia (PN) 30-day mortality rate Represents a new measure for the FY 2014 Program not in the FY 2013 Program.
7 FY 2015 Finalized Domains and Measures/Dimensions 12 Clinical Process of Care Measures Domain Weights 8 Patient Experience of Care Dimensions 1. AMI-7a Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival 2. AMI-8 Primary PCI Received Within 90 Minutes of Hospital Arrival 3. HF-1 Discharge Instructions 4. PN-3b Blood Cultures Performed in the ED Prior to Initial Antibiotic Received in Hospital 5. PN-6 Initial Antibiotic Selection for CAP in Immunocompetent Patient 6. SCIP-Inf-1 Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision 7. SCIP-Inf-2 Prophylactic Antibiotic Selection for Surgical Patients 8. SCIP-Inf-3 Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery 9. SCIP-Inf-4 Cardiac Surgery Patients with Controlled 6AM Postoperative Serum Glucose 10. SCIP Inf 9 Postoperative Urinary Catheter Removal on Post Operative Day 1 or SCIP-Card-2 Surgery Patients on a Beta Blocker Prior to Arrival That Received a Beta Blocker During the Perioperative Period 12. SCIP-VTE-2 Surgery Patients Who Received Appropriate Venous Thromboembolism Prophylaxis Within 24 Hours Efficiency, 20% Outcome, 30% Clinical Process of Care, 20% Patient Experience of Care, 30% 1. Nurse Communication 2. Doctor Communication 3. Hospital Staff Responsiveness 4. Pain Management 5. Medicine Communication 6. Hospital Cleanliness & Quietness 7. Discharge Information 8. Overall Hospital Rating 5 Outcome Measures 1. MORT-30-AMI Acute Myocardial Infarction (AMI) 30-day mortality rate 2. MORT-30-HF Heart Failure (HF) 30-day mortality rate 3. MORT-30-PN Pneumonia (PN) 30-day mortality rate 4. PSI-90 Patient safety for selected indicators (composite) 5. CLABSI Central Line-Associated Blood Stream Infection 1 Efficiency Measure 1. MSPB-1 Medicare Spending per Beneficiary measure Represents a new measure for the FY 2015 program not in the FY 2014 program.
8 Physician Quality Reporting System (PQRS) and Value Modifier PQRS incentive: ends in 2014 PQRS payment adjustment: starts in 2013; overlaps with the incentive for 2 years Value Modifier: first reporting year is 2013; affects payment in 2015 Must include all providers by payment year 2017 (measurement year 2015)
9 Value-Based Payment Modifier Value Modifier Scoring: Combine each quality measure into a quality composite and each cost measure into a cost composite using the following domains: Clinical care Patient experience Patient safety Care coordination Quality of Care Composite Score VALUE MODIFIER AMOUNT Efficiency Total overall costs Total costs for beneficiaries with specific conditions Cost Composite Score
10 Reducing Hospital Readmissions (ACA Sec. 3025) Readmissions penalties for applicable hospitals starting FY 13 The FY 2012 IPPS/LTCH PPS Final Rule sets forth: Conditions and readmissions to which program will apply for the first program year Readmission measures/methodology and calculation of readmission rates (e.g., CMS will use 30-day AMI, HF, and PN measures based on 3 years of data: July 1, 08 - June 30, 11) Public reporting of readmission data Next year s (FY13) proposed rule will include specific information regarding payment adjustment For more information, see:
11 From: Association Between Quality Improvement for Care Transitions in Communities and Rehospitalizations Among Medicare Beneficiaries JAMA. 2013;309(4): doi: /jama Figure Legend: Means (solid lines) and upper and lower control limits (dashed lines) set by the experience of Vertical dotted line indicates start of quality improvement in the intervention communities. Date of download: 2/1/2013 Copyright 2012 American Medical Association. All rights reserved.
12 Accountable Care Organizations 259 ACOs 221 Medicare Shared Savings Program ACOs 35 also participating in the Advance Payment Model 32 Pioneer ACOs 6 Physician Group Practices Over 4 million beneficiaries receiving care from ACO providers
13 Results: ACO Participation is Growing Rapidly All ACOs Assigned Beneficiaries by County (4.0 million total) Source:
14 Pioneer ACOs Succeed in Improving Care, Lowering Costs Key results for performance year 1: 40% Pioneer ACOs produced shared savings with CMS, generating a gross savings of $87.6 million in 2012 and a net savings of $33 million to Medicare. Costs for Pioneer ACO beneficiaries grew by only 0.3%. This is below historical Medicare growth rates and well below the 0.8% growth rate for similar beneficiaries. As a group, Pioneer ACOs generated gross savings of $87.6 million, or 1.2 percent savings on a total benchmark of $7.59 billion for over 669,000 beneficiaries. 13 Pioneer ACOs earned shared savings totaling $76.09 million. 18 Pioneer ACOs generated savings while 14 generated losses. 2 Pioneer ACOS owe preliminary shared losses totaling nearly $4.0 million. Pioneer ACOs successfully reported quality measures and performed better than the Medicare feefor-service population on a variety of measures, such as blood pressure and cholesterol control measures
15 Bundled Payments: 4 Models Model 1 Model 2 Model 3 Model 4 Episode All acute patients, all DRGs Selected DRGs + post-acute period Post acute only for selected DRGs Selected DRGs Services included in the bundle All part A DRGbased payments Part A and B services during the initial inpatient stay, post-acute period and readmissions Part A and B services during the post-acute period and readmissions All Part A and B services (hospital, physician) and readmissions Payment Retrospective Retrospective Retrospective Prospective Participants 3 representing 32 health care facilities 55 representing 195 health care organizations 14 representing 165 health care organizations 37 representing 75 health care facilities 15
16 The Health Insurance Marketplace A new way to get health insurance Enrollment starts October 1, 2013 Coverage begins January 2014 About 25 million Americans will have access to quality health insurance Up to 20 million may qualify for help to make it more affordable Working families can get help through the Marketplace
17 Learn More
18 Contact Information David W. Saÿen Regional Administrator San Francisco Regional Office Centers for Medicare & Medicaid Services
Value-based incentive payment percentage 3
Report Run Date: 07/12/2013 Hospital Value-Based Purchasing Value-Based Percentage Payment Summary Report Page 1 of 5 Percentage Summary Report Data as of 1 : 07/08/2013 Total Score Facility State National
More informationInnovative Coordinated Care Delivery
Innovative Coordinated Care Delivery The Arizona Readmissions Summit 2015, Mesa David W. Saÿen, MBA Regional Administrator Centers for Medicare & Medicaid Services San Francisco February 12, 2015 OUR STRATEGIC
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 informationCMS Value Based Purchasing: The Wave of the Future
CMS Value Based Purchasing: The Wave of the Future Ninth National Pay for Performance Summit David Saÿen, MBA Regional Administrator Centers for Medicare & Medicaid Services San Francisco Betsy L. Thompson,
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 informationModel VBP FY2014 Worksheet Instructions and Reference Guide
Model VBP FY2014 Worksheet Instructions and Reference Guide This material was prepared by Qualis Health, the Medicare Quality Improvement Organization for Idaho and Washington, under a contract with the
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 informationObjectives. Integrating Performance Improvement with Publicly Reported Quality Metrics, Value-Based Purchasing Incentives and ISO 9001/9004
Integrating Performance Improvement with Publicly Reported Quality Metrics, Value-Based Purchasing Incentives and ISO 9001/9004 Session: C658 2013 ANCC National Magnet Conference Thursday, October 3, 2013
More informationValue Based Purchasing
Value Based Purchasing Baylor Health Care System Leadership Summit October 26, 2011 Sheri Winsper, RN, MSN, MSHA Vice President for Performance Measurement & Reporting Institute for Health Care Research
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 informationHospital Value-Based Purchasing (At a Glance)
Hospital Value-Based Purchasing (At a Glance) Healthcare Financial Management Association South Carolina Chapter March 20, 2012 Presenters: Linda Moore, RN, Manager of Federal Programs and Services, CCME
More informationPASSPORT ecare NEXT AND THE AFFORDABLE CARE ACT
REVENUE CYCLE INSIGHTS PATIENT ACCESS PASSPORT ecare NEXT AND THE AFFORDABLE CARE ACT Maximizing Reimbursements For Acute Care Hospitals Executive Summary The Affordable Care Act (ACA) authorizes several
More informationKANSAS SURGERY & RECOVERY CENTER
Hospital Reporting Period for Clinical Process Measures: Fourth Quarter 2012 through Third Quarter 2013 Discharges Page 2 of 13 Hospital Quality Measures Your Hospital Aggregate for All Four Quarters 10
More informationThe Wave of the Future: Value-Based Purchasing & the Impact of Quality Reporting Within the Revenue Cycle
The Wave of the Future: Value-Based Purchasing & the Impact of Quality Reporting Within the Revenue Cycle Kim Charland, BA, RHIT, CCS Senior Vice President Clinical Innovation and Publisher VBPmonitor
More informationQuality Care Amongst Clinical Commotion: Daily Challenges in the Care Environment
Quality Care Amongst Clinical Commotion: Daily Challenges in the Care Environment presented by Sherry Kwater, MSM,BSN,RN Chief Nursing Officer Penn State Hershey Medical Center Objectives 1. Understand
More informationHospital Inpatient Quality Reporting (IQR) Program Measures (Calendar Year 2012 Discharges - Revised)
The purpose of this document is to provide a reference guide on submission and Hospital details for Quality Improvement Organizations (QIOs) and hospitals for the Hospital Inpatient Quality Reporting (IQR)
More informationNEW JERSEY HOSPITAL PERFORMANCE REPORT 2014 DATA PUBLISHED 2016 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2014 DATA PUBLISHED 2016 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment
More informationOur Hospital s Value Based Purchasing (VBP) Journey
Our Hospital s Value Based Purchasing (VBP) Journey Linnea Huinker, MHA, Clinical Effectiveness Specialist Katie Potts, MHA, Clinical Effectiveness Specialist January 31, 2013 Presentation Outline Hospital
More informationDianne Feeney, Associate Director of Quality Initiatives. Measurement
HSCRC Quality Based Reimbursement Program Dianne Feeney, Associate Director of Quality Initiatives Sule Calikoglu, Associate Director of Performance Measurement 1 Quality Initiative Timeline Phase I: Quality
More informationFacility State National
Percentage Summary Report Page 1 of 5 Data As Of: 07/27/2016 Total Performance Facility State National 35.250000000000 37.325750561167 35.561361414483 Unweighted Domain Weighting Weighted Domain Clinical
More informationCare Coordination What Matters
Care Coordination What Matters Researchers, Improvers, Providers, Patients and Caregivers Jane Brock, MD, MSPH Telligen 2 A little background how did we get here? Transitional care/care coordination A
More informationAn Overview of the. Measures. Reporting Initiative. bwinkle 11/12
An Overview of the National Hospital Quality Measures A National Voluntary Hospital Reporting Initiative bwinkle 11/12 What Are Hospital Quality Measures? The Joint Commission (TJC) and the Centers for
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 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 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 informationNEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment
More informationIMPROVING HCAHPS, PATIENT MORTALITY AND READMISSION: MAXIMIZING REIMBURSEMENTS IN THE AGE OF HEALTHCARE REFORM
IMPROVING HCAHPS, PATIENT MORTALITY AND READMISSION: MAXIMIZING REIMBURSEMENTS IN THE AGE OF HEALTHCARE REFORM OVERVIEW Using data from 1,879 healthcare organizations across the United States, we examined
More informationMedicare Inpatient Prospective Payment System
Program Summary Medicare Inpatient Prospective Payment System Program Year: FFY 2013 Proposed Rule Table of Contents Overview... 1 Inpatient Payment Rates... 1 Updates to the Federal Operating, Hospital
More informationThe Patient Protection and Affordable Care Act of 2010
INVITED COMMENTARY Laying a Foundation for Success in the Medicare Hospital Value-Based Purchasing Program Steve Lawler, Brian Floyd The Centers for Medicare & Medicaid Services (CMS) is seeking to transform
More informationHIT Incentives: Issues of Concern to Hospitals in the CMS Proposed Meaningful Use Stage 2 Rule
HIT Incentives: Issues of Concern to Hospitals in the CMS Proposed Meaningful Use Stage 2 Rule Lori Mihalich-Levin, J.D. lmlevin@aamc.org; 202-828-0599 Jennifer Faerberg jfaerberg@aamc.org; 202-862-6221
More informationMedicare Payment Strategy
Data and Analytics Medicare Payment Strategy CMS Inpatient Pay For Performance Program Update Eric Fontana, Practice Manager, Data and Analytics Group analytics@advisory.com 2011 THE ADVISORY BOARD COMPANY
More informationState of the State: Hospital Performance in Pennsylvania October 2015
State of the State: Hospital Performance in Pennsylvania October 2015 1 Measuring Hospital Performance Progress in Pennsylvania: Process Measures 2 PA Hospital Performance: Process Measures We examined
More informationImproving quality of care during inpatient hospital stays
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 Office of Communications FACT SHEET FOR IMMEDIATE RELEASE Contact:
More informationOlutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA
Olutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA Introduce the methods of using core measures to compare quality of health care US hospitals provide Have
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 information2013 Health Care Regulatory Update. January 8, 2013
2013 Health Care Regulatory Update January 8, 2013 Quality-Based Payment Reform, ACOs and Clinical Integration Bruce Johnson and Tom Donohoe Overview Quality-based payment reform programs Major programs
More informationFINAL RECOMMENDATION REGARDING MODIFYING THE QUALITY- BASED REIMBURSEMENT INITIATIVE AFTER STATE FY 2010
FINAL RECOMMENDATION REGARDING MODIFYING THE QUALITY- BASED REIMBURSEMENT INITIATIVE AFTER STATE FY 2010 Health Services Cost Review Commission 4160 Patterson Avenue Baltimore, MD 21215 (410) 764-2605
More informationFFY 2018 IPPS PROPOSED RULE CHA MEMBER FORUM
FFY 2018 IPPS PROPOSED RULE CHA MEMBER FORUM June 1, 2:00 3:30 p.m. (PT) Dial-in: 1-888-317-6003 Passcode: 7542838 Adobe Connect: http://connect1.calhospital.org/ipps/ Objectives Review proposed changes
More informationHealthcare Transformation and the Affordable Care Act David Nilasena, MD, MSPH, MS Chief Medical Officer, CMS Region VI
National Readmission Prevention Collaborative Dallas, TX October 22, 2015 Healthcare Transformation and the Affordable Care Act David Nilasena, MD, MSPH, MS Chief Medical Officer, CMS Region VI Disclaimers
More informationPAY FOR PERFORMANCE AND VALUE BASED PURCHASING: Leigh Humphrey, MBA, LMSW, CPHQ
PAY FOR PERFORMANCE AND VALUE BASED PURCHASING: Leigh Humphrey, MBA, LMSW, CPHQ Objectives Define what Pay for Performance is and why CMS wants us to move in this direction Describe the process of how
More informationConnecting the Revenue and Reimbursement Cycles
Connecting the Revenue and Reimbursement Cycles Tuesday, August 19 th, 2014 Toni G. Cesta, Ph.D., RN, FAAN Consultant and Partner Case Management Concepts New York Office And Bev Cunningham, MS, RN Vice
More informationValue Based Purchasing: Improving Healthcare Outcomes Using the Right Incentives
Value Based Purchasing: Improving Healthcare Outcomes Using the Right Incentives One (1.0) Contact Hour Course Expires: 1/15/2015 Course Published: 12/10/2013 Reproduction and distribution of these materials
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 informationThe Data Game. Vicky A. Mahn-DiNicola RN, MS, CPHQ VP Research & Market Insights
The Data Game Vicky A. Mahn-DiNicola RN, MS, CPHQ VP Research & Market Insights My Primary Objective Today: Review Upcoming Regulatory Changes Review of Proposed IPPS Rule for FY 2016 CMS-1632-P 45 CFR
More informationFinancial Policy & Financial Reporting. Jay Andrews VP of Financial Policy
Financial Policy & Financial Reporting Jay Andrews VP of Financial Policy 1 Members & Groups Supported Center for Healthcare Excellence Hospital Leadership & Quality Departments Hospital Finance Departments
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 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 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 informationPerson-Centered Care and Population Health
Physician Leader Forum Person-Centered Care and Population Health ZIAD HAYDAR, MD, MBA Chief Medical Officer Ascension Health 2013 by the Catholic Health Association of the United States Outline Describe
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 informationOVERVIEW OF THE FY 2018 IPPS FINAL RULE. Published in the Federal Register August 14 th Rule to take effect October 1 st
OVERVIEW OF THE FY 2018 IPPS FINAL RULE S UM M ARY OF CALCULATI ON ELEMENTS Published in the Federal Register August 14 th Rule to take effect October 1 st INDEX TO FFY 2018 CHANGES IN IPPS FACTORS Payment
More informationCME Disclosure. HCAHPS- Hardwiring Your Hospital for Pay-for-Performance Success. Accreditation Statement. Designation of Credit.
CME Disclosure Accreditation Statement Studer Group is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Designation
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 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 informationCenters for Medicare & Medicaid Services (CMS) Quality Improvement Program Measures for Acute Care Hospitals - Fiscal Year (FY) 2020 Payment Update
ID Me asure Name NQF # Value- (VBP) - (HACRP) (HRRP) ID Me asure Name NQF # Value- (VBP) - (HACRP) (HRRP) CMS s - Fiscal Year 2020 Centers for Medicare & Medicaid Services (CMS) Improvement s for Acute
More informationNew Mexico Hospital Association
New Mexico Hospital Association Hospital Quality Reporting Guide Revised: November 2014 TABLE OF CONTENTS Regulatory Landscape at a Glance... 4 Key Terms and Undserstanding Timeframes... 5 Hospital Inpatient
More informationMinnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide
More informationNational Hospital Inpatient Quality Reporting Measures Specifications Manual
National Hospital Inpatient Quality Reporting Measures Specifications Manual Release Notes Version: 4.4a Release Notes Completed: October 21, 2014 Guidelines for Using Release Notes Release Notes 4.4a
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 informationValue 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 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 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 informationMEDICARE BENEFICIARY QUALITY IMPROVEMENT PROJECT (MBQIP)
MEDICARE BENEFICIARY QUALITY IMPROVEMENT PROJECT (MBQIP) Began in September 2011 Key quality improvement activity within the Medicare Rural Hospital Flexibility grant program Goal of MBQIP: to improve
More informationAn Update on CMS Quality Programs: Pharmacists can shine in new era of patient outcomes and efficiency!
An Update on CMS Quality Programs: Pharmacists can shine in new era of patient outcomes and efficiency! Steven M. Riddle, PharmD, BCPS, FASHP Vice President of Clinical Affairs Pharmacy OneSource/ Wolters
More informationImproving Compliance
Improving Compliance * The following planners, speakers, moderators, and/or panelists of this CME activity have no relevant financial relationships with commercial interests to disclose: Mary B. Johnson
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 informationNext Generation of Healthcare in the World of ACOs and VBP
Next Generation of Healthcare in the World of ACOs and VBP Arizona February 10, 2014 Identifying ways to align physicians and quality directors is the leading edge on our success or failure to delivering
More informationIs Emergency Department Quality Related to Other Hospital Quality Domains?
ORIGINAL CONTRIBUTION Is Emergency Department Quality Related to Other Hospital Quality Domains? Megan McHugh, PhD, Jennifer Neimeyer, PhD, Emilie Powell, MD, MS, Rahul K. Khare, MD, MS, and James G. Adams,
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 informationOverview of DataGen Analyses Wyoming Hospital Association
Overview of DataGen nalyses Wyoming Hospital ssociation Bill Shyne, anager September 20, 2017 genda Who is DataGen and why partnership exists Data sources utilized Overview of analyses available to WH
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 informationNational Patient Safety Goals & Quality Measures CY 2017
National Patient Safety Goals & Quality Measures CY 2017 General Clinical Orientation 2017 January National Patient Safety Goals 1. Identify Patients Correctly 2. Improve Staff Communication 3. Use Medications
More informationCMS Quality Program- Outcome Measures. Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: December 2015 Revised: January 2018
CMS Quality Program- Outcome Measures Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: December 2015 Revised: January 2018 Philosophy The Centers for Medicare and Medicaid Services (CMS) is changing
More informationPresented by: Gara Edelstein, CNO, CHS & St. Catherine of Siena Nicolette Fiore-Lopez, CNO, St. Charles Hospital Susan Penque, CNO, South Nassau
Presented by: Gara Edelstein, CNO, CHS & St. Catherine of Siena Nicolette Fiore-Lopez, CNO, St. Charles Hospital Susan Penque, CNO, South Nassau Communities Hospital Valerie Terzano, CNO, Winthrop University
More informationQ & A with Premier: Implications for ecqms Under the CMS Update
Q & A with Premier: Implications for ecqms Under the CMS Update Lori Harrington Senior Director, Quality and regulatory solutions Premier, Inc. Aisha Pittman Director, Quality policy and analysis Premier,
More informationUpdates from CMS: Value-Based Purchasing, ACOs, and Other Initiatives The Seventh National Pay for Performance Summit March 20, 2012
Updates from CMS: Value-Based Purchasing, ACOs, and Other Initiatives The Seventh National Pay for Performance Summit March 20, 2012 Presenters David Sayen, CMS Regional Administrator Betsy L. Thompson,
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 informationVolume to Value Transition in the USA
Volume to Value Transition in the USA Lee A. Fleisher, M.D. Robert D. Dripps Professor and Chair of Anesthesiology Perelman School of Medicine at the University of Pennsylvania Email: lee.fleisher@uphs.upenn.edu
More informationMinnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654 Minnesota Department of Health October 2011 Division of Health Policy Health Economics
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 informationWA Flex Program Medicare Beneficiary Quality Improvement Program
WA Flex Program Medicare Beneficiary Quality Improvement Program Medicare Rural Hospital Flexibility Grant Program Assist CAHs by providing funding to state governments to encourage quality and performance
More informationHospital Compare Quality Measure Results for Oregon CAHs: 2015
KEY FINDINGS: Flex Monitoring Team STATE DATA REPORT February 2017 Hospital Compare Quality Measure Results for Oregon : 2015 Michelle Casey, MS; Tami Swenson, PhD; Alex Evenson, MA University of Minnesota
More informationMinnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide
More informationTo Admit or Not to Admit: How Do We Answer this Question?
To Admit or Not to Admit: How Do We Answer this Question? Charleeda Redman RN, MSN, ACM Vice President, Accountable Care Email: redmanca@upmc.edu ACMA WPA Chapter Conference October 6, 2012 Four Points
More informationHospital Value-Based Purchasing (VBP) Program
Fiscal Year (FY) 2018 Percentage Payment Summary Report (PPSR) Overview Questions & Answers Moderator Maria Gugliuzza, MBA Project Manager, Hospital VBP Program Hospital Inpatient Value, Incentives, 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 informationFY 2015 Inpatient PPS Final Rule Teleconference September 16, 2014
FY 2015 Inpatient PPS Final Rule Teleconference September 16, 2014 AAMC Staff: Allison Cohen, acohen@aamc.org Lori Mihalich-Levin, lmlevin@aamc.org Scott Wetzel, swetzel@aamc.org Mary Wheatley, mwheatley@aamc.org
More informationReinventing Health Care: Health System Transformation
Reinventing Health Care: Health System Transformation Aspen Institute Patrick Conway, M.D., MSc CMS Chief Medical Officer Director, Center for Clinical Standards and Quality Acting Director, Center for
More informationCopyright 2015 Wolters Kluwer Health, Inc. All rights reserved.
24 May 2015 Nursing Management www.nursingmanagement.com 2.5 CONTACT HOURS Value-Based Just a few years ago, we were in the infancy of the Centers for Medicare and Medicaid Services (CMS) Value-Based Purchasing
More informationMastering the Mandatory Elements of the Affordable Care Act. Melinda Hancock Walter Coleman
Mastering the Mandatory Elements of the Affordable Care Act Melinda Hancock Walter Coleman 1 ACA Gains through 2019 Amounts in Billions Source:CBO and Joint Committee on Taxation, 2010 Projection 2 Current
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 informationHCAHPS. Presented by: Bill Sexton. Proudly recognized as one of the Nation s Top 100 Critical Access Hospitals - ivantage Health Analytics
HCAHPS Presented by: Bill Sexton HCAHPS results will impact your organization's reimbursement in the era of health care reform HCAPHS results are a quality metric, not just a patient satisfaction metric
More informationCY 2012 Medicare Outpatient Prospective Payment System (OPPS) Final Rule
CY 2012 Medicare Outpatient Prospective Payment System (OPPS) Final Rule Lori Mihalich-Levin, J.D. (lmlevin@aamc.org; 202-828-0599) Jennifer Faerberg (jfaerberg@aamc.org; 202-862-6221) Jane Eilbacher (jeilbacher@aamc.org;
More informationHow Your Hospital s Total Performance Score (TPS) Will Impact Your Medicare Payments
WHITE PAPER: How Your Hospital s Total Performance Score (TPS) Authors: Brooke Palkie, EdD, RHIA and David Marc, MBA, CHDA Copyright 2015 Panacea Healthcare Solutions, Inc. All Rights Reserved As a follow-up
More informationJune 27, Dear Ms. Tavenner:
1275 K Street, NW, Suite 1000 Washington, DC 20005-4006 Phone: 202/789-1890 Fax: 202/789-1899 apicinfo@apic.org www.apic.org June 27, 2014 Ms. Marilyn Tavenner Administrator Centers for Medicare & Medicaid
More informationQuality Based Impacts to Medicare Inpatient Payments
Quality Based Impacts to Medicare Inpatient Payments Brian Herdman Operations Manager, CBIZ KA Consulting Services, LLC July 30, 2015 Overview How did we get here? Summary of IPPS Quality Programs Hospital
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 informationSurgical Care Improvement Project
Safer Surgeries: Surgical Care Improvement Project Leslie N. Ray Ph.D., RN Oregon Patient Safety Commission Ruth Medak, MD Acumentra Health What is SCIP? National effort to decrease preventable surgical
More informationMBQIP ABBREVIATIONS. Angiotensin Converting Enzyme Inhibitor. American Congress of Obstetricians and Gynecologists
MBQIP ABBREVIATIONS A ACE-1 ACOG ARB ACA ADE AHA AHRQ AMI APIC Angiotensin Converting Enzyme Inhibitor American Congress of Obstetricians and Gynecologists Angiotensin Receptor Blocker Affordable Care
More informationValue based care: A system overhaul
Value based care: A system overhaul Lee A. Fleisher, M.D. Robert D. Dripps Professor and Chair of Anesthesiology Perelman School of Medicine at the University of Pennsylvania Email: lee.fleisher@uphs.upenn.edu
More information