IDIOT’S GUIDE TO CMS, VBP, HCAHPS, CPC, TPS OR, WHY CAN’T I JUST PRACTICE GOOD CLINICAL MEDICINE...
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Transcript of IDIOT’S GUIDE TO CMS, VBP, HCAHPS, CPC, TPS OR, WHY CAN’T I JUST PRACTICE GOOD CLINICAL MEDICINE...
IDIOT’S GUIDE TO
CMS,
VBP, HCAHPS, C
PC, TP
S
O R , WH Y C A N ’ T I J U S T P R A C T I C E G O O D C L I N I C A L M
E D I C I N E
A N D H A V E A L L O F Y O U F I G U R E O U T T H I S B S ?
$URVIVALAt Risk: significant revenue to our hospital based on measures over which
we have little: Awareness Control over the measuring process Control over outcomes beyond our own practice System in place to ensure quality control
CAN WE REVERSE THIS? YES!!! WE NEED TO TAKE THE BULL BY THE HORNS.
SIMPLE DEFINITIONSCMS = Center for Medicare/Medicaid ServicesVBP = Value Based PurchasingHCAHPs = Scores based on random surveys of patients recently
hospitalizedCPCs = Clinical Processes of CareOutcomes Domain Measure (ODM)TPS = Total Performance Score
TPS = HCAHPs + CPCs + ODM (30%) (40%) (30%)
WHAT SHOULD
YOU ASK
YOURSELF?
W H E N ? WH Y ? H
O W ? WH E R E ? C
A N I H E L P ?
TIME FRAMES: PERFORMANCE IS NOT PREDICTABLE IN A CHAOTIC SYSTEM
Measured by
others
Measured by us
Measured by us
HCAHPS SCORES
CPC ACHIEVEMENT & BENCHMARKS
OUTCOMES ACHIEVEMENT & BENCHMARKS
BAD TIMES? – BETTER TIMES?Pre-Performance Period (Judgment Days):HCAHPS/CPCs: April 2011 to March 2012 – What was going on then?
All resources diverted to preparing for ccLinkDisgruntled staff pissed off about not having a
summer vacationDenis Mahar came back to the county without his
beard?Pre-Performance Period (Judgment Days):Outcomes Measures: July 2008 to June 2011
Performance Period (Real Judgment Days):HCAHPS/CPCs: April 2012 to December 2012Outcomes Measures – July 2011 to June 2012
HOW DO WE REVERSE THIS?As Medical Staff Leaders, We Need To:Understand the processUnderstand the measuresUnderstand how to accurately interpret and communicate this
process & measures to our staff membersTake responsibility for the measures that are the outcomes of
our departmentsDemand accountability from ourselves; our
quality/administrative leaders; our colleagues and our Board