Tuesday, 26 January 2016 03:01

New Data Shining Spotlight on Care Quality

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On Dec. 10, 2015, the Centers for Medicare & Medicaid Services (CMS) updated and released the following:

New performance data for hospitals on the Hospital Compare website, including timely and effective care measure data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS):

https://www.medicare.gov/hospitalcompare/search.html

The data identified 758 hospitals that will see their Medicare payments reduced by 1 percent for ranking in the bottom quartile nationally:

https://www.medicare.gov/hospitalcompare/HAC-reduction-program.html

Hospital Compare is targeted to provide the public more aggregate data on the various quality measures reported to CMS. It does not provide the implications of performance, nor the pace of improvement to the CMS database, which is what drives the reimbursement and penalty distribution curve.

The Value-Based Purchasing (VBP) Program is a self-funded program. If an organization’s pace of change is not exceeding that of the data base, organizations still making improvements can be surprised to find that they are on the wrong side of the improvement curve at the end of the year and paying penalties (rather than seeing a financial upside). Quarterly forecasting of the CMS database movement is critical.

Organizations need tools that provide:

  • The ability to review hospital performance by domain and measure and assess the financial implications of that performance;
  • The ability to forecast financial performance related to quality activities;
  • Focus for quality and safety initiatives in areas most strategically important to their pay-for-performance financial impacts; and
  • Forecasting of the pace of change of the CMS database quarterly to ensure that the organization’s pace of improvement exceeds that of the database (to be on the right side of the bell curve).

About the Author

Debbie is a partner and chief operating officer for DCCS. She has a broad background of CEO, COO, and operations leadership in systems (CHW, SCLHS, CHI) and freestanding health systems across the country. She brings experience in moving organizations forward to consulting and interim senior leadership and operating positions and has a strong strategic and clinical background with outstanding physician relations skills. She rejuvenates underperforming organizations and programs, raising performance and profitability, and develops leadership and workplace cultures that lead to high levels of performance and employee satisfaction.

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Last modified on Tuesday, 26 January 2016 03:04

Debbie is a Partner and Chief Operating Officer for DCCS. She has a broad background of CEO, COO, Operations leadership in systems (CHW, SCLHS, CHI) and free standing health systems across the country. She brings experience in moving organizations forward to Consulting and Interim senior leadership and operating positions and has a strong strategic and clinical background with outstanding physician relations skills. She rejuvenates underperforming organizations and programs, raising performance and profitability and develops leadership and workplace cultures that lead to high levels performance and employee satisfaction. Core skills include: Vision/Strategic Planning, Operations Improvement, Physician Practice Operations, Leadership Development, Clinical Quality/Patient Safety, Service Excellence, Service Line Development, Population Management, Mergers/Acquisitions, Physician Alignment, Ambulatory and Physician Services, Workplace Culture Development