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Quality Improvement Programs

One Year Since CMS Cracked Down on Readmissions | Where Are We Now?

2017-04-02T13:28:31-04:00By |Care Coordination, Clinical Analysis, Health Care Reform, Physician Compensation, Quality Improvement Programs, Readmissions, Services, Telehealth and Telemedicine|

October 1st of last year, CMS cracked down on readmission rates for hospitals nationwide, handing out millions of dollars in penalties. The Affordable Care Act put these measures into place in order to curb the problem of readmissions, which are not only costly, but reflect an overall poor population health in the U.S. - especially for those patients with chronic conditions. For FY ‘14, 2% was withheld from payments per the guidelines for penalties. By 2015, the rate of withholding for penalties is expected to top 3%. In addition to the higher payments, there will also be additional diagnoses included in the readmission criteria list - it began with heart attacks, pneumonia and heart failure and will now expand to include COPD and complications from chronic lung conditions.

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5 Values You Should Value in Physician Compensation Models

2017-04-02T13:28:32-04:00By |Financial Analysis, Physician Compensation, Quality Improvement Programs, Services|

When it comes to shifting models of physician compensation, there are many considerations ,and at times, it can be difficult to decide where your focus, as a physician or a payer, should be. As we move toward value-based payment models, we might want to consider what values already exist within our healthcare organizations that will be reflective of this shift - and by supporting them, we can lead the charge to newer payment models.

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Increasing Patient Satisfaction Through Revenue Cycle Improvement

2017-04-02T13:28:33-04:00By |Financial, Quality Improvement Programs|

One element of revenue cycle improvement that will be coming to the forefront with the implementation of patient-centered care is patient loyalty. As a hospital, your staff and facility might provide a patient with top-notch care. Overall, they may emerge healed and satisfied with how they were treated - but then, they get their bill! If your hospital’s billing department isn’t equipped to continue that positive patient experience after the patient is discharged, you may be losing patients.

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Should Hospitals Design with Patients in Mind?

2017-04-02T13:28:34-04:00By |Health Care Reform, Operational Analysis, Quality Improvement Programs|

Build It - And They Will Come? Maybe Not. It’s no secret to anyone in the healthcare industry that there’s a huge emphasis on patient satisfaction scores these days - predominantly because they are so closely linked with reimbursement in the new healthcare landscape. Hospitals are taking ‘satisfaction’ a step further- how about patient aesthetic?

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Good Medicine Is More Than an HCAHPS Score

2017-04-02T13:28:34-04:00By |Clinical Analysis, Clinical Operations Improvement, Quality Improvement Programs, Services|

Improving patient satisfaction is a laudable and necessary goal for any hospital, particularly when revenue is at risk based on patients’ opinions regarding quality of care. But patient satisfaction measures should not be confused with good medicine – a nobler objective that delivers richer results. Scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) can bring bonuses to hospitals that do well on the survey. Those that don’t may risk losing some Medicare funding under the Hospital Value-Based Purchasing Program. So it’s understandable that hospitals care a great deal about HCAHPS. But the survey scores should not be seen as a proxy for good medicine.

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The Penalty Box | CMS’ 3 Ways to Ding Hospitals

2017-04-02T13:28:35-04:00By |Compliance, Financial, Financial Analysis, Health Care Reform, Medicare and Medicaid, Quality Improvement Programs, Readmissions, Services|

Are you one of many hospitals being dinged with CMS penalties? Are you ready to be dinged for Hospital Acquired Conditions, in addition to readmissions and value-based purchasing? How can a hospital remain profitable? In terms of hockey, the penalty box is where players are sent when they have committed an act which is against the regulations of the game. The player is forced to sit in the penalty box for a period of time, causing the team to play with less players, until the penalty time has lapsed.

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The Quest for Healthcare Quality Part III: Providers & HCAHPS

2017-04-02T13:28:36-04:00By |Big Data, Organizational Analysis, Quality Improvement Programs|

When it comes to assessing healthcare quality, we’ve already talked about the trouble with defining ‘quality’, the patient’s perspective and touched on the value of HCAHPS data. The final piece of the puzzle is how do healthcare organizations, hospitals and providers use the HCAHPS data to improve their outcomes?

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The Quest for Healthcare Quality Part II: Patient Perspectives

2017-04-02T13:28:36-04:00By |Big Data, Quality Improvement Programs|

When it comes to defining healthcare quality, the opinion of the patients might be the most important of all. They are, after all, the ones on the receiving end of care. When you strip away the financial concerns, the administrative politics and all the other things that make healthcare a business, we remember that the end is that we will provide care to patients in need. Their experience of that care, when quantified, can give providers and hospitals a baseline evaluation of their strengths and weaknesses as a healthcare organization.

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