Document

Report
HCAHPS And Value
Based Purchasing 101
Truths of Current Healthcare
Climate
• HCAHPS/VBP are not going away.
• Healthcare is a business-All organizations must
generate a profit.
• Reimbursement is based on outcomes not effort.
• Patients are our mission and the mission ALWAYS
comes first.
• The Golden Rule applies to all situations.
• Nursing staff now has the unique opportunity to
become a revenue generator instead of a cost
center.
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What is CAHPS?
Consumer Assessment of Healthcare Providers and Systems
 Produces comparable data for public reporting
 Creates incentive for organizations to improve
 Enhances public accountability and transparency
Hospital CAHPS
Home Health Care CAHPS
Clinician and Group CAHPS
… more to come!
CAHPS provides an apples to apples metric for public
reporting—additional measurement may be needed for ongoing
quality improvement activities and monitoring.
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4 Objectives of HCAHPS
• Standardization permits meaningful comparisons across
hospitals for public reporting
• Increased hospital accountability and incentives for quality
improvement
• Pay-for-performance (Hospital VBP)
• Enhanced public accountability
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Why is CAHPS ® Important?
 Consumers have access to the data
®
 Consumers relate more easily to CAHPS data than to clinical
data
®
 Some use CAHPS data to choose hospitals
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CAHPS is in the public eye
Media coverage
Promotion by hospitals themselves
Participation linked to reimbursement
Will have volume, revenue, and reputation implications down the
road
http://www.medicare.gov/hospitalcompare/search.html
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HCAHPS Survey
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HCAHPS Content: Seven
Composites
• 1.Communication with nurses
•
- Nursing related questions comprise about 50% of Survey
• 2.Communication with doctors
• 3. Responsiveness of hospital staff
• 4. Pain management
• 5.Communication about medicines
• 6. Discharge information
• 7. Care Transition
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Other Questions You Impact
Hospital Environment
 During this hospital stay, how often were your room & bathroom kept
clean?
 Never, sometimes, usually, always
 During this hospital stay, how often was the area around your room quiet at
night?
 Never, sometimes, usually, always
Global Rating
 Using any number from 0 to 10, where 0 is the worst hospital possible and
10 is the best hospital possible, what number would you use to rate this
hospital during your stay?
 0-worst—10-best possible hospital
 Would you recommend this hospital to your friends & family?
 Definitely no, probably no, probably yes, definitely yes
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General Survey Guidelines
Patient Eligibility
 Adult (18+)
 Medical, surgical or maternity care
 Overnight stay, or longer
 Alive at discharge
 Excludes hospice discharge, prisoner, foreign address, “nopublicity” patients, patients excluded due to state regulations,
and patients discharged to nursing homes, SNF swing bed
within hospital, and skilled nursing facilities
 HCAHPS encompasses ~80-85% of inpatients
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Communication Guidelines
 Hospitals SHOULD
 Encourage response to the survey
 “It is permissible to notify the patient while in the hospital or at discharge
that they may receive a survey after discharge.”
 Improve the patient experience
 Distribute the communication guidelines
 Hospitals SHOULD NOT
 Ask patients for a certain score
 Indicate that their goal is to receive a certain score
 New: Show the HCAHPS survey or cover letter to the patient prior to
survey administration
 New: Mail pre-notification letter or postcards
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Value Based
Purchasing
Value-Based Purchasing
Common Terminology: Pay for performance or Pay for quality
Health Reform Updates
Value Based Purchasing started in fiscal 2013
Current hospital VBP program will transition from “Pay-for-Reporting” to “Pay-for
Performance”
Up to 2% of your Medicare reimbursement will be at stake
 Hospitals will lose reimbursement unless their performance is at benchmark
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levels
Includes HCAHPS performance and Core Measures
Will start at 1% and this will be ramped up to 2% by 2017
Who will be reimbursed for HCAHPS performance?
 Top performing healthcare providers
 Greatest improving healthcare providers
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Hospital Value Based Purchasing - Measures
Future Measures
 AHRQ patient safety indicators, inpatient quality indicators and composite
measures
 Nursing sensitive care
 AMI, heart failure and pneumonia mortality rates
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Thank you for
attending!
http://www.medicare.gov/hospitalcompare/search.htm
ww.cms.gov
www.hcahpsonline.org
www.pressganey.com

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