Post on 07-May-2015
description
Meaningful USE Stage 2 & 3 PATIENT ENGAGEMENT
OVERVIEW
MEANINGFUL USE : A LOOK BACK THE GOV & PATIENT ENGAGEMENT ACOs AND PATIENT ENGAGEMENT VALUE-BASED REIMBURSEMENT & PATIENT ENGAGEMENT
Meaningful USE: A LOOK BACK
Meaningful Use: A Look Back
$11.8 Billion in Total Incentives Program to Date
Meaningful Use: A Look Back
$11.8 Billion in Total Incentives Program to Date o $2.4 Billion in Medicare Incentives Paid –
Hospitals/Providers
Meaningful Use: A Look Back
$11.8 Billion in Total Incentives Program to Date o $2.4 Billion in Medicare Incentives Paid –
Hospitals/Providers o $1.8 Billion in Medicaid Incentives Paid –
Hospitals/Providers
Meaningful Use: A Look Back
$11.8 Billion in Total Incentives Program to Date o $2.4 Billion in Medicare Incentives Paid
– Hospitals/Providers o $1.8 Billion in Medicaid Incentives Paid
– Hospitals/Providers o $7.3 Billion in Medicare/Medicaid to
Hospitals
Meaningful Use: A Look Back
o 372,000 Hospitals / Professionals registered
Meaningful Use: A Look Back
o 372,000 Hospitals / Professionals registered
o 49 States, D.C. and PR have launched
Medicaid Programs * Hawaii, Guam, Am. Samoa – Unknown * Virgin Islands – Unknown
Meaningful Use: A Look Back
Active Registrations:
Meaningful Use: A Look Back
Active Registrations:
o Hospitals → 4,257 (5,724 in U.S. – 74%)
Meaningful Use: A Look Back
Active Registrations:
o Hospitals → 4,257 (5,724 in U.S. – 74%) o Medicare Eligible Providers → 253,477 (834,769
U.S. Physicians – 30%)
Meaningful Use: A Look Back
Active Registrations:
o Hospitals → 4,257 (5,724 in U.S. – 74%) o Medicare Eligible Providers → 253,477 (834,769
U.S. Physicians – 30%) o Medicaid Eligible Providers → 114,866 (U.S.
Physicians – 14%)
Meaningful Use: A Look Back
Total Attestation:
Meaningful Use: A Look Back
Total Attestation:
o Hospital Attestation → $7,861,299,090
Meaningful Use: A Look Back
Total Attestation:
o Hospital Attestation → $7,861,299,090
o Medicare EP Stage 1 Attestation →
$2,134,906,925
Meaningful Use: A Look Back
Total Attestation:
o Hospital Attestation → $7,861,299,090
o Medicare EP Stage 1 Attestation →
$2,134,906,925
o Medicaid EP Year 1 & 2 Attestation →
$1,595,896,115
The government & PATIENT-CENTERED CARE
Gov & PCC
• 23 % of federal budget goes to health care • 36 times ACA mentions Patient Centeredness • 15 times ACA references the Medical Home • 93 times ACA references Quality Measures • 29 times ACA links Quality to reporting Clinical Data • 100 times ACA discusses Value-Based and Payment
Modifiers as relates to Hospital/MD Reimbursement and Measures*
Gov & PCC
o Federal Government → Leadership role in Health Care Reform
Gov & PCC
o Federal Government → Leadership role in Health Care Reform
o Transition is happening: Move from Episodic Care →
Long-Term Healing and Wellness
Gov & PCC
How?
Gov & PCC
How? Government is using principles of behavioral
economics to better long-term care & lower costs.
Gov & PCC
What is behavioral economics?
Gov & PCC
What is behavioral economics? "Behavioral economics explains why people are
predictably irrational and provides tools for redirecting their behavior with carefully deployed nudges and financial incentives” - New England Journal of Medicine
Gov & PCC Behavioral economics & Healthcare =
Gov & PCC Behavioral economics & Healthcare = 1. Better ways to motivate patients to improve and
protect their own health using technologies like wireless devices
Gov & PCC Behavioral economics & Healthcare = 1. Better ways to motivate patients to improve and
protect their own health using technologies like wireless devices
2. New reimbursement strategies for health care providers
that require them focus more closely on patients' health outside of office visits and hospitalizations.
Gov & PCC
Behavioral Economics is about patient engagement & patient-centered care.
Gov & PCC
Behavioral Economics is about patient engagement & patient-centered care.
Patient-centered care: model of care that supports active involvement of
patients and their families in decision-making.
Gov & PCC The IOM (Institute of Medicine) defines patient-
centered care as: "Providing care that is respectful of and
responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions."
Gov & PCC
• Federal Policymaking grounded in Patient Centered Care:
o Regs CMS Meaningful Use Stage 2 - 7 Measures o Regs CMS Accountable Care Organizations (ACOs) – 7
Measures o Regs CMS Value-based Purchasing – Differential Payment
Based on Quality o Regs CMS Public Measure Transparency – Physician
Compare Website o Other Agency Initiatives – CMS PCORI, HRSA PCMH and
VA PACT
Proposed stage 2 core measures
Accountable Care Organizations & PATIENT ENGAGEMENT
ACOs and Patient Engagement
o 33 Quality Performance Measures
ACOs and Patient Engagement
o 33 Quality Performance Measures o 7 Patient / Caregiver Experience
ACOs and Patient Engagement
o 33 Quality Performance Measures o 7 Patient / Caregiver Experience
ACOs and Patient Engagement
Final Rule: Requires CMS qualified Survey Vendor by 2014
ACOs and Patient Engagement
• HITPC Preliminary Stage 3 Draft (Aug → Final Recommendations expected in Nov)
ACOs and Patient Engagement
• HITPC Preliminary Stage 3 Draft (Aug → Final Recommendations expected in Nov)
o Patients Option to submit data online → 10% submit Medical Histories
ACOs and Patient Engagement
• HITPC Preliminary Stage 3 Draft (Aug → Final Recommendations expected in Nov)
o Patients Option to submit data online → 10% submit Medical Histories
o Patient education in non-English languages
ACOs and Patient Engagement
• HITPC Preliminary Stage 3 Draft (Aug → Final Recommendations expected in Nov)
o Patients Option to submit data online → 10% submit Medical Histories
o Patient education in non-English languages o 10% of Patients ability to update and correct
information online
ACOs and Patient Engagement
Value-Based Payment & PATIENT ENGAGEMENT
VBP & Patient Engagement
o Started October 1, 2012
VBP & Patient Engagement
o Started October 1, 2012 o Evaluated / Scored on performance
improvements over baseline
VBP & Patient Engagement o Hospitals → CMS payment adjustments based
on patient experience
VBP & Patient Engagement o Hospitals → CMS payment adjustments based
on patient experience o ACA has Physician VBM program starting in 2015
based on 2013 performance
VBP & Patient Engagement
HCAHPS scores will rate hospitals based on patient experience
* The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patients' perspectives of hospital care.
VBP & Patient Engagement
HCAHPS scores will rate hospitals based on patient experience, e.g.
VBP & Patient Engagement
HCAHPS scores will rate hospitals based on patient experience, e.g.
– patient satisfaction
VBP & Patient Engagement
HCAHPS scores will rate hospitals based on patient experience, e.g.
– patient satisfaction – customer service
VBP & Patient Engagement
HCAHPS scores will rate hospitals based on patient experience, e.g.
– patient satisfaction – customer service – communication training
VBP & Patient Engagement
Results published on Hospital Compare website
VBP & Patient Engagement
Results published on Hospital Compare website Physician Compare website now in place to show performance metrics - first publishing (limited) in
CY2013
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