watch the lecture in the file and follow the detials written below

this is a 300 words post and 2 short responsesAll, there are notes provided for each slide, just make the slide take up less of your screen and you should see them at the bottom.Also, I have narrated the entire presentation. I am providing a very high level of information, the notes should fill in some of the additional detail. Additionally there is much written about these topics, do additional resources as needed.Use this presentation to complete the new Discussion Board Assignment.using the powerpoint provided on Value Based Purchasing and other Quality measures for hospitals please provide one meaningful post on one of the topics covered in the presentation.Provide a meaningful response to two other posts.PAY FOR PERFORMANCE = VALUE BASED PROGRAMS
CMS VALUE BASED PURCHASING (VBP)
CMS HOSPITAL READMISSION REDUCTION
PROGRAM (HRRP)
VALUE
BASED
PROGRAMS
CMS HOSPITAL ACQUIRED CONDITIONS (HAC)
ANTHEM Q-HIP
UNITED HOSPITAL PERFORMANCE BASED
COMPENSATION (HPBC)
AETNA PERFORMANCE IMPROVEMENT
PROGRAM (PIP)
Pay for Performance at Deaconess
CLINICAL CARE 25%
• AMI MORTALITY RATE
• HF MORTALITY RATE
• PN MORTALITY RATE
• COPD MORTALITY RATE
• CABG MORTALITY RATE
• HIP/KNEE REPLACEMENT COMPLICATIONS
PERSON & COMMUNITY ENGAGEMENT 25%
• NURSE COMMUNICATION
• DOCTOR COMMUNICATION
• CLEANLINESS AND QUIETNESS
• RESPONSIVENESS OF STAFF
• COMMUNICATION ABOUT MEDS
• DISCHARGE INSTRUCTIONS
• OVERALL RATING
• CARE TRANSITIONS
SAFETY 25%
• CLABSI
• CAUTI
• SSI COLON
• SSI ABDOMINAL HYSTERECTOMY
• C. DIFF
• MRSA
• PC 01 (ELECTIVE DELIVERIES)
EFFICIENCY 25%
• MEDICARE SPENDING PER BENEFICIARY
Measure Explanations

Mortality
 Patient
expires 30 days from the date of admission
 Risk adjusted
◼ Severity
of illness
◼ Risk of mortality


HCAHPS- Hospital Consumer Assessment of
Healthcare Providers and Systems
CAUTI, CLABSI, SSI, PSI
 Hospital

Acquired Conditions/Infections (HAC/HAI)
Medicare Spend Per Beneficiary (MSPB)
3
days prior, inpatient admission, 30 days after
discharge
HRRP Cohorts and Dates


AMI, Heart Failure, Pneumonia, COPD, Total Hip
Replacement, Total Knee Replacement, CABG
FY 2019


FY 2020 (current fiscal year)


July 1, 2016- June 30, 2019
FY 2022 (current performance period)


July 1, 2015- June 30, 2018
FY 2021


July 1, 2014- June 30, 2017
July 1, 2017- June 30, 2020
FY 2023

July 1, 2018- June 30, 2021
30 Day Readmissions

Index Admission
 Admitted
as an inpatient for AMI, HF, PN, COPD,
THA/TKA, CABG

Readmission
 Admitted
as an inpatient to any facility 30 days from
date of discharge for any reason
HAC Domains and Dates

Domain 1: PSI 90
Domain 2: CAUTI, CLABSI, SSI Colon, SSI Abdominal
Hysterectomy, MRSA, C. diff

FY 2020 (current fiscal year)

 Domain
1: July 1, 2016- June 30, 2018
 Domain 2: Calendar Years 2017 and 2018
HAC Measures

PSI 90
 Composite

of individual Patient Safety Indicators
CAUTI
 Catheter-Associated

CLABSI
 Central

Urinary Tract Infections
Line-Associated Bloodstream Infection
SSI
 Surgical
Site Infection
Commercial Programs





Anthem, United and Aetna
Similar measures to CMS programs
Different time periods
Payer specific data
Hospital Specific
Measure
VBP
HRRP
HAC
Anthem
United
Aetna
HCAHPS Nurse Communication
x
x
x
HCAHPS Doctor Communication
x
x
x
HCAHPS Hospital Environment
x
x
HCAHPS Responsiveness of Staff
x
x
HCAHPS Pain Management
x
HCAHPS Communication about
Meds
x
x
x
HCAHPS Discharge Information
x
x
x
HCAHPS Overall Rating
x
x
x
HCAHPS Care Transitions
x
x
CLABSI
x
x
x
x
CAUTI
x
x
x
x
SSI Colon
x
x
x
x
C. Diff
x
x
x
x
MRSA
x
x
x
x
Readmissions
Hip/Knee Complications
x
x
x
x
x
x
Financial Impact







Value Based Purchasing: 2% of payments
Hospital Readmission Reduction: 3% of payments
Hospital Acquired Conditions: 1% of payments
Anthem: tiered rate increase
United: rate increase
Aetna: rate increase
Total at Risk
 Over
$15,000,000

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