Showing posts with label CMS. Show all posts
Showing posts with label CMS. Show all posts

Thursday, April 2, 2009

Pay-For-Performance Coming To Nursing Homes

CMS is kicking off a five state pay-for-performance (P4P) demonstration project that will help them design incentives for quality improvement in nursing homes. They're calling it Nursing Home Value-Based Purchasing.

Arizona, Mississippi, New York and Wisconsin have been chosen to be the host states. Nursing homes in these states are invited to participate.


Basically how the demonstration project will work is over the next couple years CMS will collect quality data on participating nursing homes, assign scores based on performance and compare those scores to other nursing homes in the state overall and over time.


CMS will determine how much money is saved as a result of nursing homes' improvements and then allocate those cost savings to the best-performers in the form of incentive payments.


However if it is determined that nursing homes in a particular state did not improve overall, no incentive payments will be disbursed...no matter how well a particular nursing home performed.


If you're considering participating in the demonstration and would like assistance, Enovasis can guide you through it. Enovasis can also identify and implement improvements to increase the likelihood of receiving incentive payments. Contact us today.

For more information about the demonstration or to apply for participation visit www.nhvbp.com.

Thursday, September 25, 2008

CMS Update: 13 New Quality Measures

CMS has adopted 13 of their 43 proposed new quality measures for FFY 2010. One measure, pneumonia oxygenation, has been retired, bringing the total to be reported to 42 (full list of CMS quality measures).

Two additional measures are expected to be approved next year, bringing the total up to 44. These are AMI and Pneumonia Readmit rates. Enovasis analysts expect one new measure in particular may be of concern for many hospitals: The Heart Failure 30-day Risk Standardized Readmission Measure.


According to MedPac, readmissions cost Medicare $15 billion every year—$12 billion of which is believed to be preventable. Almost 18% of Medicare patients are re-admitted to a hospital within 30 days of discharge.
The Heart Failure re-admission measure, to be calculated automatically using Medicare claims data, may prove to be a source of many improvement efforts, time and resources. With this information becoming publicly available, hospitals should start monitoring and improving this rate as soon as possible.

Many hospitals have initiatives to reduce length of stay in the high-volume, high-cost heart failure category, but few monitor the repercussions of those initiatives closely. One major repercussion being a high readmission rate. If this rate is high at your hospital investigate your use of home care or other post-discharge treatment. Also analyze readmits by discharge day of the week or by post-acute provider to find clues as to what is causing returns.

Contact Enovasis Healthcare Solutions if you need assistance.