Diese Präsentation wurde erfolgreich gemeldet.
Wir verwenden Ihre LinkedIn Profilangaben und Informationen zu Ihren Aktivitäten, um Anzeigen zu personalisieren und Ihnen relevantere Inhalte anzuzeigen. Sie können Ihre Anzeigeneinstellungen jederzeit ändern.

CMS Reporting Requirements - 4 Changes Hospitals Need to Know for 2014

32.852 Aufrufe

Veröffentlicht am

Hospitals need to be proactive to avoid the penalties from CMS’ reporting measures. In specific, there are 4 changes to be aware of: 1) Value based purchasing will include two additional outcome measures: CLABSI and PSI. 2) The Readmissions Reduction Program will be expanded to include COPD and THA/TKA, plus there’s a proposed 3 percent penalty for readmission. 3) Under the new proposed HAC Reduction Program, hospitals with the highest rate of HACs will receive a 1 percent reduction in Medicare inpatient payments. 4) Medicare proposes to align reporting for the Electronic Health Record and Inpatient Quality Reporting.

Veröffentlicht in: Gesundheit & Medizin
  • Loggen Sie sich ein, um Kommentare anzuzeigen.

CMS Reporting Requirements - 4 Changes Hospitals Need to Know for 2014

  1. 1. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. © 2014 Health Catalyst www.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation. CMS Reporting Requirements-4 Changes Hospitals Need to Know for 2014 By Bobbi Brown & Michael Barton
  2. 2. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Surviving the New CMS Standards To survive the Centers for Medicare & Medicaid Services’ (CMS) new reporting measures, hospitals must proactively improve their quality scores. Significant changes are coming in 2014 and those healthcare providers unprepared to meet the new CMS standards will face severe financial setbacks, or worse – go out of business.
  3. 3. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Upcoming CMS Changes Considering the context of recent CMS changes it’s increasing clear that the long term strategy is to reduce reimbursements to facilities that fail to meet quality benchmarks. Hospital systems must achieve an active understanding of the CMS changes to be prepared for the new healthcare climate. Here are four proposed changes for 2014.
  4. 4. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital Value-Based Purchasing Program Established by the Affordable Care Act, the hospital value- based purchasing (VBP) program adjusts payments (in the form of penalties and bonuses) to hospitals based on the quality of care they provide. Hospitals are rewarded for best clinical practices and how well they enhance the patient experience of care. 2014 CMS REPORTING CHANGES 1
  5. 5. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital Value-Based Purchasing Program For fiscal year 2015, the portion of Medicare payments available to fund the value-based incentive payments will increase to 1.5 percent of the base operating diagnosis-related group (DRG) payment. According to CMS estimates, the total amount available for value-based incentive payments in FY 2015 will be approximately $1.4 billion. 2014 CMS REPORTING CHANGES 1
  6. 6. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital Value-Based Purchasing Program There will also be two new outcomes measures for 2015: AHRQ Patient Safety Indicators (PSI) composite and central line-associated blood steam infection (CLABSI). The total performance score for each hospital will be calculated by using these percentages: 2014 CMS REPORTING CHANGES 1 Clinical Process: 20% Patient Process: 30% Outcomes: 30% Efficiency: 20%
  7. 7. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital Readmissions Reduction Program The Hospital Readmissions Reduction Program is the government’s attempt to reduce hospital readmissions for patients who’ve recently been admitted for certain conditions or procedures. For FY 2015, CMS proposed adding COPD and THA/THK (total hip & total knee arthroplasty) to the list of conditions. 2014 CMS REPORTING CHANGES 2
  8. 8. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital Readmissions Reduction Program 2014 CMS REPORTING CHANGES 2 Health Catalyst’s Readmission Explorer tool displays easy-to-understand trends, comparisons, and detailed, patient-level data through an uncluttered user interface.
  9. 9. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital Inpatient Quality Reporting 2014 CMS REPORTING CHANGES 3 CMS is proposing to align the reporting and submission timelines for clinical quality measures for the Medicare Electronic Health Record (EHR) Incentive Program with the Hospital Inpatient Quality Reporting (IQR) Program established in 2003. Hospitals risk losing 2% of payments (up from 0.4%) for failing to meet the new standards.
  10. 10. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital-Acquired Condition (HAC) Reduction Program 2014 CMS REPORTING CHANGES 4 The Hospital-Acquired Condition (HAC) Reduction Program is the newest CMS quality program. This program penalizes hospitals for high HAC rates. The HAC Reduction Program penalty begins in October 2014
  11. 11. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital-Acquired Condition (HAC) Reduction Program 2014 CMS REPORTING CHANGES 4 Under the HAC Reduction Program, hospitals with the highest rate of HACs — specifically, those in the top 25 percent — will receive a 1 percent reduction in Medicare inpatient payments. CMS estimates 753 hospitals will be subject to the one percent reduction and overall payments will decrease by $330 million (0.3%)
  12. 12. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Hospital-Acquired Condition (HAC) Reduction Program 2014 CMS REPORTING CHANGES 4 CMS has categorized HAC measurements in two domains: Domain 1 includes the AHRQ PSI-90 composite measure consisting of these indicators: PSI 3 Pressure ulcer rate PSI 6 Latrogenic pneumothorax rate PSI 7 Central venous catheter-related blood stream infection rate PSI 8 Postoperative hip fracture rate PSI 12 Postoperative pulmonary embolism (PE) or deep vein thrombosis rate (DVT) PSI 13 Postoperative sepsis rate PSI 14 Wound dehiscence rate PSI 15 Accidental puncture and laceration rate Domain 2 consists of the Center for Disease Control and Prevention’s NHSN (National Healthcare Safety Network) CAUTI and CLABSI measures. CAUTI is catheter-associated urinary tract infection and CLABSI is central-line associated blood stream infection. For CMS scoring Domain 1 weights 35% and Domain 2 weights 65%
  13. 13. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Needed: A Systematic Approach to Improve Quality and Cost Changes from the government will be ongoing — and CMS will continue to relentlessly increase their cost and penalty measures through various improvement programs. To survive the new quality requirements hospitals must develop a systematic and ongoing approach to improve quality and cost to keep up with these yearly mandates.
  14. 14. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Conclusion Improving quality performance and meeting CMS measurements can only be driven by using the right system level information and analytic processes. Such a reporting system, combined with getting the right clinical teams in place to solve quality issues, can change a hospital’s culture and keep up with the ongoing CMS evolution.
  15. 15. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Other related articles: Read about why a systematic approach to healthcare will help you achieve quality improvement despite the ever- changing CMS guidelines. Learn how Texas Children’s Hospital used a system-wide strategy to leverage their EHR by aggregating their data into a healthcare enterprise data warehouse (EDW). Here’s a useful article about how moving from meaningful use to meaningful analytics will help you improve quality and reduce costs. See our how Analytics Adoption Model provides the framework you need to succeed with CMS’ reporting requirements.
  16. 16. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Other Clinical Quality Improvement Resources Bobbi Brown is Vice President of Financial Engagement for Health Catalyst, a data warehousing and analytics company based in Salt Lake City. Ms. Brown started her healthcare career at Intermountain Healthcare supporting clinical integration efforts before moving to Sutter Health and, later, Kaiser Permanente, where she served as Vice President of Financial Planning and Performance. Ms. Brown holds an MBA from the Thunderbird School of Global Management as well as a BA in Spanish and Education from Misericordia University. She regularly writes and teaches on finance-related healthcare topics. Michael Barton joined Health Catalyst as Vice President in January 2013. He completed his training at the University of Utah Health Sciences Center. Upon graduation in 1994, he was employed with the Pharmacoepidemiology Team, a multidisciplinary team of epidemiologists, infection control practitioners, quality control specialists, pharmacists, and healthcare IT specialists at the University of Utah. After four years, Michael moved his clinical practice to the Shock-Trauma ICU at LDS Hospital. Here, he had the opportunity to apply his infectious disease and critical care knowledge. After eight years of clinical practice in conjunction with five years of IT industry consulting experience, Michael joined HIT startup TheraDoc, Inc. as a consultant in 2000 and full-time in 2001. Michael spent 12 years with TheraDoc, where he served in various roles. The last 5 years Michael served on the senior leadership team as SVP, Knowledge and Product Development where Michael oversaw the Knowledge Management, Product Management, Engineering, and Quality teams. For Michael, joining Health Catalyst means continuing to pursue his passion of improving the quality and safety of patient care through applied healthcare IT solutions. Click to read additional information at www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.

×