Transcript Document
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. 2 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. 3 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 4 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 ® 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 5 HCAHPS Survey 6 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 7 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 8 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 9 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 10 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 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 12 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 13 Thank you for attending! http://www.medicare.gov/hospitalcompare/search.htm ww.cms.gov www.hcahpsonline.org www.pressganey.com