Hospital Value Based Purchasing Program - Midas Plus · Hospital Value Based Purchasing Program ......

Hospital Value Based Purchasing Program: Part 2 of 4: A Detailed Review of the Final CMS FY 2014 IPPS Rule

- 1 -

Hospital Value Based Purchasing Program Part 2 of 4 of Our Review of the IPPS 2014 Final Rule

Hospital Readmission

Reduction Program

Inpatient Hospital & Psychiatric

Quality Program

Hospital Acquired

Conditions Reduction Program

Hospital Value Based

Purchasing Program

- 2 -

Welcome and Introductions

- 3 -

Vicky Mahn DiNicola RN, MS, CPHQ

VP Research and Market Insights

Midas+ Xerox

Follow me at https://twitter.com/MidasXerox to keep up with

Regulatory Changes Impacting Quality Reporting Requirements!

Questions regarding this briefing may be submitted directly to me

in a private email simply by clicking on the comment bubble in the

tool bar at the bottom right of your presentation screen, or you

may contact me directly by sending me an email to

[email protected]

https://twitter.com/MidasXerox



mailto:[email protected]

Review of

Final IPPS

Rule for

FY 2014

CMS-1599-F

CMS-1455-F Posted to

Federal Registry

August 19, 2013

http://www.gpo.gov/fdsys/

pkg/FR-2013-08-

19/pdf/2013-18956.pdf

- 4 -

Hospital Value Based

Purchasing

- 5 -

FY 2013

FY 2014

FY 2015

FY 2016

FY 2017

1.0 1.25 1.50 1.75 2.0

Funding pool started with 1.00 percent of the base-operating DRG

FY 2014 Funding Pool estimated at 1.1 Billion

Applies to subsection (d) hospitals

Maryland Hospitals Exempt

October 1, 2013 to

September 30, 2014

Each Measure Worth 0 to 10 Points Points are dependent upon your hospital’s performance

against the rest of the nation

Achievement

Threshold

Benchmark

40

National Median (50th Percentile) during a

baseline period with respect to a fiscal year

Note: This definition does not apply to the Medicare

Spending per Beneficiary Measure; which is the

median (50th percentile) of hospital performance on

a measure during the performance period with

respect to a fiscal year

Arithmetic mean of the top decile (10th Percentile)

during a baseline period with respect to a fiscal year

Note: This definition does not apply to the Medicare

Spending per Beneficiary Measure; which is the

arithmetic mean of the top decile of hospital performance

on a measure during the performance period with

respect to a fiscal year

Definitions have been clarified in the FY 2014 IPPS/LTCH Rule

Each Measure Worth 10 Points AMI-8a Primary PCI within 90 minutes of Arrival

95.34%

100%

Achievement

Threshold

Benchmark

= Your Hospital’s Performance beginning with Discharges January 1, 2013

0 Points

Performance Period

January 1, 2013 to

December 31, 2013

40

Each Measure Worth 10 Points AMI-8a Primary PCI within 90 minutes of Arrival

95.34%

100%

Achievement

Threshold

Benchmark

10 Points

Performance Period

January 1, 2013 to

December 31, 2013

= Your Hospital’s Performance beginning with Discharges January 1, 2013

40

Achievement Range

1 2 3 4 5 6 7 8 9 10

Achievement Points AMI-8a Primary PCI within 90 minutes of Arrival

95.34%

100%

Achievement Threshold

Benchmark

7 Points

For hospitals that score better than half the hospitals in the US

they can Score “Achievement Points” based on a linear scale between the

Achievement threshold and the Benchmark

98%

Performance Period

January 1, 2013 to

December 31, 2013

f 40

Improvement Points AMI-8a Primary PCI within 90 minutes of Arrival

Achievement Threshold

Benchmark

82%

95.34%

Baseline Period Jan 2011 – Dec 2011

Performance Period Jan 2013 – Dec 2013

Improvement Range

1 2 3 4 5 6 7 8 9

A unique improvement range for each

measure will be established for each

hospital that defines the distance between

the hospital’s baseline period score and the

national benchmark score

100%

98%

8 Points

40

The improvement threshold is an individual hospital’s

performance level on a measure during the baseline period

with respect to a fiscal year

- 11 -

Clinical Process of Care

45% Patient Experience

of Care 30%

Outcome 25%

FY 2014 Value-Based Purchasing Domains (Payment Determination for Discharges from October 1, 2013 to September 30, 2014)

FY 2014 Value-Based Purchasing Patient Experience Domain (Payment Determination for Discharges from October 1, 2013 to September 30, 2014)

- 12 -

8 Patient Experience of Care Measures

Baseline Period April 1, 2010 to December 31, 2010

Performance Period April 1, 2012 to December 31, 2012

HCAHPS Survey Dimensions Floor(%) Threshold (%) Benchmark (%)

Communication with Nurses 42.84 75.79 84.99

Communication with Doctors 55.49 79.57 88.45

Responsiveness of hospital staff 32.15 62.21 78.08

Pain management 40.79 68.99 77.92

Communications about

medications

36.01 59.85 71.54

Cleanliness and quietness 38.52 63.54 78.10

Discharge information 54.73 82.72 89.24

Overall rating of hospital 30.91 67.33 82.55

FY 2014 Value-Based Purchasing Clinical Process of Care Domain (Payment Determination for Discharges from October 1, 2013 to September 30, 2014)

- 13 -

13 Clinical Process of Care Measures

Baseline Period April 1, 2010 to December 31, 2010

Performance Period April 1, 2012 to December 31, 2012

Measures Threshold (%) Benchmark (%)

AMI 7a Fibrinolytic agent received 30 minutes of hospital arrival 80.66 96.30

AMI 8a PCI received 90 minutes of hospital arrival 93.44 100.O0

HF 1 Discharge Instructions 92.66 100.00

PN 3b Blood culture before 1st antibiotic received in hospital 97.30 100.00

PN 6 Initial antibiotic selection for CAP immunocompetent patient 94.46 100.00

SCIP 1 Antibiotic 1 hr before incision or 2 hrs if Vancomycin/Quinolone 98.07 100.00

SCIP 2 Received antibiotic consistent with recommendations 98.13 100.00

SCIP 3 Prophylactic Antibiotic Discontinued w/in 24 hrs surgery end time 96.63 99.96

SCIP 4 Controlled 6 AM postop glucose for cardiac surgery 96.34 100.00

SCIP 9 Postop urinary catheter removed postop day 1 or 2 92.86 99.89

SCIP-Card 2 Pre-admission beta blocker and periop beta blocker 95.65 100.00

SCIP-VTE-1 Recommended VTE prophylaxis ordered during stay 94.62 100.00

SCIP-VTE-2 Received VTE prophylaxis w/in 24 hrs prior to or after surgery 94.62 99.83

FY 2014 Value-Based Purchasing Outcome Domain (Payment Determination for Discharges from October 1, 2013 to September 30, 2014)

- 14 -

Three Outcome of Care Mortality Measures

Baseline Period July 1, 2009 to June 30, 2010

Performance Period July 1, 2011 to June 30, 2012


Acute MI 30-day Mortality Rate 84.77 86.73

Heart Failure 30-day Mortality Rate 88.61 90.42

Pneumonia 30-day Mortality Rate 88.18 90.21

All New for FY 2014

Upcoming Shifts in Domain Weighting

- 15 -

Clinical Process of Care 20%

Patient Experience

of Care 30%

Outcome 30%

Efficiency 20%

FY 2014 FY 2015


45%

Patient Experience

of Care 30%

Outcome 25%

Established in the FY 2013 IPPS/LTCH IPPS Final Rule

Hospitals must have sufficient data in at least two domains to calculate a total performance score

FY 2015 Value-Based Purchasing Experience of Care Domain (Payment Determination for Discharges from October 1, 2014 to September 30, 2015)

- 16 -

* No change in measures but

Communication with Nurses

had the largest increase in Floor

values (up 4.93 percentage points)


Baseline Period January 1, 2011 to December 31, 2011

Performance Period January 1, 2013 to December 31, 2013

HCAHPS Survey

Dimensions Floor(%) Threshold (%) Benchmark (%)

Communication

with Nurses

47.77 76.56 85.70

Communication with

Doctors

55.62 79.88 88.79

Responsiveness of

hospital staff

35.10 63.17 79.06


Communications

about medications

35.48 60.89 71.85

Cleanliness and

quietness

41.94 64.07 78.90

Discharge

information

57.67 83.54 89.72

Overall rating of

hospital

32.82 67.96 83.44

Established in the FY 2013 IPPS/LTCH PPS Final Rule


Experience of Care

30%

Outcome 30%

Efficiency 20%

FY 2015 Value-Based Purchasing Clinical Process of Care Domain (Payment Determination for Discharges from October 1, 2014 to September 30, 2015)

- 17 -





AMI 7a Fibrinolytic agent received 30 minutes

of hospital arrival

80.00 100.00

AMI 8a PCI received 90 minutes of arrival 95.34 100.O0

HF 1 Discharge Instructions 92.09 100.00

PN 3b Blood culture before 1st antibiotic

received in hospital

94.11 100.00

PN 6 Initial antibiotic selection for CAP

immunocompetent patient

97.78 100.00

SCIP 1 Antibiotic 1 hr before incision or 2 hrs if

Vancomycin/Quinolone

97.17 100.00

SCIP 2 Received antibiotic consistent with

recommendations

98.63 100.00

SCIP 3 Prophylactic Antibiotic Discontinued

w/in 24 hrs surgery end time

98.63 100.00

SCIP 4 Controlled 6 AM postop glucose for

cardiac surgery

97.49 100.00

SCIP 9 Postop urinary catheter removed

postop day 1 or 2

95.79 99.76

SCIP-Card 2 Pre-admission beta blocker and

periop beta blocker

95.91 100.00

SCIP-VTE-1 Recommended VTE

prophylaxis ordered during stay

94.62 100.00

SCIP-VTE-2 Received VTE prophylaxis w/in 24 hrs

prior to or after surgery

94.89 99.99

SCIP VTE 1 removed

from FY 2015 Measures



Experience of Care

30%

Outcome 30%

Efficiency 20%

- 18 -


Baseline Period October 1, 2010 to June 30, 2011

Performance Period October 1, 2012 to June 30, 2013





FY 2015 Value-Based Purchasing Outcome Domain (Payment Determination for Discharges from October 1, 2014 to September 30, 2015)

New! One Complication/Patient Safety Measure



Measures Threshold Benchmark (%)

AHRQ PSI-90 Composite .622879 .451792

New! One Hospital Acquired Infection Measure


Performance Period February 1, 2013 to December 31, 2013


CLABSI (Standardized infection ratio) .4370 00.00



Experience of Care

30%

Outcome 30%

Efficiency 20%

FY 2015 Value-Based Purchasing Efficiency Domain (Payment Determination for Discharges from October 1, 2014 to September 30, 2015)


Experience of Care

30%

Outcome 30%

Efficiency 20%

- 19 -

New! One Cost of Care Efficiency Measure

Baseline Period May 1, 2011 to December 31, 2011

Performance Period May 1, 2013 to December 31, 2013


MSPB-1 Medicare

spending per

beneficiary

Median Medicare

spending per

beneficiary ratio

across all

hospitals during

performance

period

Mean of 10th

percentile of

Medicare

spending per

beneficiary ratios

across all

hospitals during

performance

period


Changing Shifts in Domain Weighting

- 20 -


Patient Experience

of Care 30%

Outcome 30%

Efficiency 20%

FY 2015


10%

Patient Experience

of Care 25%

Outcome 40%

Efficiency 25%

FY 2016

Hospitals must have sufficient data in at least two domains to calculate a total performance score

- 21 -

FY 2016 VBP




HCAHPS Survey

Dimensions Floor(%) Threshold (%) Benchmark (%)

Communication with

Nurses

53.99 77.67 86.07

Communication with

Doctors

57.01 80.40 88.56

Responsiveness of

hospital staff

38.21 64.715 79.76


Communications

about medications

34.61 62.33 72.77

Cleanliness and

quietness

43.08 64.95 79.10

Discharge

information

61.36 84.70 90.39

Overall rating of

hospital

34.95 69.32 83.97

Final Changes for FY 2016 VBP Experience of Care (Payment Determination for Discharges from October 1, 2015 to September 30, 2016)


10%

Patient Experience

of Care 25%

Outcome 40%

Efficiency 25%

(Payment Determination for

Discharges from October 1,

2015 to September 30, 2016)

- 22 -

FY 2016 Value Based Purchasing





IMM-2 Influenza Immunization 90.607 98.875

AMI 7a Fibrinolytic agent received 30 minutes of

hospital arrival

91.154 100.00

PN 6 Initial antibiotic selection for CAP

immunocompetent patient

96.552 100.00

SCIP Inf-2 Received antibiotic consistent with

recommendations

99.074 100.00

SCIP Inf-3 Prophylactic Antibiotic Discontinued

w/in 24 hrs surgery end time

98.086 100.00

SCIP 9 Postop urinary catheter removed postop

day 1 or 2

97.059 100.00

SCIP-Card 2 Pre-admission beta blocker and

periop beta blocker

97.727 100.00

SCIP-VTE-2 Received VTE prophylaxis w/in 24 hrs

prior to or after surgery

98.225 100.00

AMI 8a PCI received 90 minutes of hospital

arrival

----- ------

HF 1 Discharge Instructions ----- ------

PN 3b Blood culture before 1st antibiotic

received in hospital

----- ------

SCIP 1 Antibiotic 1 hr before incision or 2 hrs if

Vancomycin/Quinolone

----- ------

SCIP-4 Controlled Glucose 6 AM post cardiac

surgery

----- ------

Five Measures to be removed

from FY 2016 VBP calculations.

AMI 8a and SCIP-Inf-1 have

topped out and HF 1 and PN 3b

have insufficient evidence to link

process to improved outcomes

NEW! Clinical Process of Care

10%

Patient Experience

of Care 25%

Outcome 40%

Efficiency 25%


10%

Patient Experience

of Care 25%

Outcome 40%

Efficiency 25%

Final Changes for FY 2016 VBP Outcome Domain (Payment Determination for Discharges from October 1, 2015 to September 30, 2016)

- 23 -

Baseline and performance values for

Hospital Acquired Infections posted in

Proposed 2014 OPPS rule to be

Finalized November 2013

Three Hospital Acquired Infection Outcome Measures




CLABSI (Standardized infection ratio of

reliability-adjusted methodology) 0.465 00.00

Catheter-Associated UTI (CAUTI) 0.801 00.00

Surgical Site Infection (weighted average

of measure strata for colon surgery and

abdominal hysterectomy)

0.668 Colon

0.752 Hysterectomy

00.00 Colon

00.00 Hysterectomy

One Complication/Patient Safety Outcome Measure



Measures Threshold Benchmark

AHRQ PSI Composite .622879 .451792








Surgical Site Infection Scoring

Weighted by Stratum

SSI-Colon

• 5 improvement points

• 1.0 predicted infections

SSI-Abdominal Hysterectomy

• 8 achievement points

• 2.0 predicted infections

- 24 -

((5 * 1.0) + (8 * 2.0)) / (1.0 + 2.0) = 7 points

One Cost of Care Efficiency Measure




MSPB-1 Medicare spending per beneficiary Median Medicare

spending per

beneficiary ratio

across all hospitals

during performance

period

Mean of lowest 10th

percentile of

Medicare spending

per beneficiary

ratios across all

hospitals during

performance period

- 25 -

No Changes other than new baseline

and performance period

Final Changes for FY 2016 VBP Efficiency Domain (Payment Determination for Discharges from October 1, 2015 to September 30, 2016)


10%

Patient Experience

of Care 25%

Outcome 40%

Efficiency 25%

During the period January 1, 2012 through December 31,

2012, the Achievement threshold would have been an

MSPB ratio of 0.98, which corresponds to a standardized,

risk-adjusted MSPB amount of $18,412, and the Benchmark

would have been 0.82, which corresponds to an MSPB

amount of $15,311.

- 26 -

FY 2017 Hospital VBP Program







AHRQ PSI-90 Complication Composite 0.577321 0.397051

Baseline and Performance Periods

are the same for Mortality and AHRQ Composite

Performance Standards and Reporting Periods

for FY 2017

- 27 -

FY 2018 Hospital VBP Program – Mortality








are the different for Mortality and AHRQ Composite

FY 2018 Hospital VBP Program – AHRQ Composite




AHRQ PSI-90 Composite

Complication/patient safety for selected

indicators

0.582626 0.398030


for FY 2018


for FY 2019

- 28 -

FY 2019 Hospital VBP Program – Mortality







FY 2019 Hospital VBP Program – AHRQ Composite

Baseline Period Pending future rule

Performance Period Pending future rule


AHRQ PSI-90 Composite

Complication/patient safety for selected

indicators

Pending future rule Pending future rule


for AHRQ Composite pending future rule making

VBP Domain Structure for FY 2017

Alignment of VBP Domains with the Six National Quality Strategy Priorities

1. Making care safer

2. Engaging patients and families

3. Effective communication and coordination of care

4. Effective prevention and treatment practices

5. Working with communities to promote health

6. Making care more affordable

- 29 -

www.ahrq.gov/workingforquality/nqs/nqs2012annlrpt.pdf

Clinical

Care

Person

Centered

Efficiency Safety

http://www.ahrq.gov/workingforquality/nqs/nqs2012annlrpt.pdf

New Measures and Domains for FY 2017

Value Based Purchasing Aligns with National Quality Strategy Domains

- 30 -

Experience & Coordination

of Care 25%

Safety 15%

Clinical Care Outcomes

25%

Clinical Care Process

10%

Efficiency & Cost

Reduction 25%

HCAHPS Survey

• CAUTI

• CLABSI

• SSI

• AHRQ PSI 90

• MSPB-1

• AMI-7a

• IMM-2

• PN-6

• SCIP-Inf-2

• SCIP-Inf-3

• SCIP-Inf-9

• SCIP-Card-2

• SCIP-VTE-2

• Mort-30-AMI

• Mort-30-HF

• Mort-30-PN

Possible Measures Being Considered in Future Rule Making

for Value Based Purchasing Program

Outcome Domain

Methicillin-resistant

Staphylococcus aureus (MRSA)

Bacteremia

Clostridium difficile (C. difficile)

Efficiency Domain

• Rate and/or dollar amount of

billing hospital inpatient services

to Medicare Part B subsequent

to the denial of a Part A hospital

inpatient claim

• Additional Medicare spending

specific to physician services

that occur during a hospital stay

• Radiology

• Anesthesiology

• Pathology

- 31 -

No measure changes finalized for FY 2017

Future Changes to Performance and Baseline

Periods for Outcome Domain

- 32 -

FY 2017 Hospital Value Based Purchasing Program

Domain Baseline Period Performance Period

Outcome

• Mortality

• AHRQ PSI Composite

October 1, 2010 to June 30, 2012






Outcome

• Mortality



July 1, 2010 to June 30, 2012


July 1, 2014 to June 30, 2016



Outcome

• Mortality


Pending future rule-making




Change to Disaster Extraordinary

Circumstances Waivers

1. Submit a waiver request to the

Hospital IQR Program within 30 days

of disaster

2. Note you also seek a waiver from the

Hospital VBP program for the program

year in which the same data could be

used as the VBP performance data

3. Submit evidence of your extraordinary

circumstance to “forestall the

possibility of hospitals attempting to

game their VBP scores”

- 33 -

Moore Hospital – May 22, 2013

- 34 -

For hospitals that submit data despite a disaster, but believe their Total Performance Scores will be negatively impacted by

their circumstances, they may be exempted from the VBP Program if exemption request is received within 90 days of event.

FY 2016 VBP Scoring Methodology

- 35 -

• No changes in scoring methodology!

• Maryland Hospitals remain exempt

So How Does CMS Spin This?

- 36 -

HCAHPS Consistency Points

HCAHPS Measures are assigned Achievement and

Improvement Points like the clinical measures

In addition, hospitals can earn anywhere from 0-20 points for

consistency in their HCAHPS scores

Consistency points are awarded proportionately based on the

single lowest of a hospital’s eight HCAHPS dimension scores

during the performance period compared to the national floor

for that specific dimension

HCHAPS Consistency Points

• If all the hospital’s dimensions score higher than the

Achievement Thresholds for each dimension the hospital

gets 20 consistency points

• That is, if the lowest hospital dimension score is at or

greater than the corresponding achievement threshold,

all 20 points are awarded

20th Annual MIDAS+ User Symposium • May 22–25, 2011 • Tucson, Arizona

HCAHPS Dimensions Hospitals Performance Period Values CMS achievement threshold

HCAHPS1 - Nurse Communication (% Always) 76% 75.18%

HCAHPS2 - Doctor Communication (% Always) 80% 79.42%

HCAHPS3 - Cleanliness and quietness (% Always) 64% 62.80%

HCAHPS4 - Responsiveness of hospital staff (% Always) 63% 61.82%

HCAHPS5 - Pain management (% Always) 69% 68.75%

HCAHPS6 - Communication about Medications (% Always) 60% 59.28%

HCAHPS7 - Discharge information (% Always) 82% 81.93%

HCAHPS8 - Overall rating 67% 66.02%


• If any one of the HCAHPS dimensions scores are lower

than “the Floor” value (zero percentile of baseline), the

hospital receives zero consistency points


HCAHPS Dimensions Hospitals Performance Period

Values CMS achievement

threshold Floor (CMS Minimum)

HCAHPS1 - Nurse Communication (% Always) 45% 75.18% 38.98

HCAHPS2 - Doctor Communication (% Always) 50% 79.42% 51.51

HCAHPS3 - Cleanliness and quietness (% Always) 64% 62.80% 36.88

HCAHPS4 - Responsiveness of hospital staff (% Always) 63% 61.82% 30.25

HCAHPS5 - Pain management (% Always) 69% 68.75% 34.76 HCAHPS6 - Communication about Medications (% Always) 60% 59.28% 29.27

HCAHPS7 - Discharge information (% Always) 82% 81.93% 50.47

HCAHPS8 - Overall rating 67% 66.02% 29.32


• If the lowest score is less than the achievement

threshold, but higher than the floor, then the consistency

points are based on the distance between the

achievement threshold and the floor for that dimension.












Formulas for Calculating HCHAPS

Consistency Points

Step 1: Calculate the “lowest dimension score” for the

lowest value across all eight HCHAPS dimensions

((Hospital’s performance period score – floor)/

(achievement threshold – floor))


Example: ((.58 – .2927)/(.5928 - .2927)) = .9573

Formulas for Calculating HCHAPS

Consistency Points

Step 2: Calculate HCHAPS Consistency Points using the

“Lowest Dimension Score” Calculated in Step 1

(20 * lowest dimension score) – 0.5 = Consistency Points (rounded to nearest whole number)


Example: (20 * (.9573) – 0.5) = 18.64 = 19 Consistency Points


• If two or more HCAHPS dimensions scores are lower

than the Achievement threshold, the measure that is

closest to the “floor” value is used for the calculation of

the “lowest dimension score”












52-51.51 = .49

45-38.98 = 6.02

Tally Up All HCAHPS Points

1. For each of the eight dimensions, determine the larger of

the achievement or improvement scores

2. Sum these eight values to arrive at a 0-80 HCAHPS base

score

3. Calculate the 0-20 HCAHPS Consistency Score

4. Sum base score and consistency score

HCAHPS total earned points = HCAHPS base score + consistency score


Calculate Total VBP Points 1. For each of the 8 Core Process Measures, determine the larger of the

achievement or improvement scores and find the sum

2. Multiply the sum of the clinical process domain by .10

3. For each of the 8 Outcome Measures (SSI strata each count as 1),

determine the larger of the achievement or improvement scores and

find the sum

4. Multiply the sum of the outcome domain by .40

5. Determine the larger of the achievement or improvement score for the

Medicare Efficiency Domain and multiple by .25

6. Multiply the HCAHPS Total Earned Points by .25

7. Sum the weighted scores together to get your Total Performance

Score (TPS).

TPS= (Sum of Process Domain Scores * .10) + (Sum of Outcome Domain Scores * .40) +

(Efficiency Domain Score * .25) + (HCAHPS Total Earned Points * .25)

How Do Points Impact Hospitals Financially?

• All hospitals will contribute 1.25% of their base operating DRG

Payment Amount in FY 2014

• VBP incentive dollars will be distributed back to hospitals based on a

linear distribution of all VBP scores nationally

• The best hospital in the nation would receive 1.817 percent extra DRG

reimbursement

• The worst hospital in the nation would receive only a 0.0236 increase

• Note this is separate from the Medicare Annual Payment Updates tied

to Hospital Inpatient Quality Reporting Program!

• Hospitals that lost their HIQR Annual Payment Update are exempt from

the VBP Program

Midas+ Value Based Purchasing Calculator

- 47 -

Shared Learning

• Submit questions or comments to [email protected]

• Download a copy of this presentation to share with others at your

organization!

• Midas+ Clients can download copy of the CMS Measure Matrix

- 48 -

mailto:[email protected]

CMS Measure Matrix

- 49 -

Midas+ Clients Only Website

- 50 -

See you for Part 3: Hospital Readmission Reduction Program

Hospital Value Based Purchasing Program - Midas Plus · Hospital Value Based Purchasing Program ......

Documents

Transcript of Hospital Value Based Purchasing Program - Midas Plus · Hospital Value Based Purchasing Program ......