TIP OF THE WEEK
Are you ready for pay for performance?
A March 2007 report to Congress by the Medicare Payment Advisory Commission (MedPAC), an independent federal body that advises the U.S. Congress on issues affecting the Medicare program, echoed recommendations made by the Institute of Medicine (IOM) for pay-for-performance (P4P) incentives for U.S. healthcare.
Both MedPAC and the IOM recommend that high quality levels and improvement toward better quality levels should be rewarded as bonuses, which should come from existing Medicare funds.
MedPAC recommends the following performance measures for P4P initiatives: incidence of acute care hospitalization*, incidence of any emergent care*, improvement in bathing, improvement in ambulation/locomotion, improvement in transferring, improvement in urinary incontinence, improvement in management of oral medications, and improvement in status of surgical wounds.
The IOM has written three reports on P4P, which present “a sense of urgency to implement P4P tempered by concerns about the limitations of current quality measures and the challenges of designing and coordinating this fundamental change in the Medicare program,” according to the March 2007 MedPAC report to Congress. The IOM recommends an evolving system that continually incorporates new measures, especially those that reach across care settings and span episodes of care, and a phased approach to implementation that includes a restricted number of conditions, a restricted number of provider types, and some initial payments for reporting.
ABT ASSOCIATES DEMONSTRATION PROJECT
As discussed during the last Centers for Medicare & Medicaid Services (CMS) home health open door forum, Abt Associates is currently designing a voluntary, two-year home health demonstration project to test performance measures, measure weighting/scoring, and incentive pool strategies. From October 2007 to September 2009, agencies that volunteer for the project will receive incentive payments based on level of performance and improvement over time. No agency will face payment reductions. Abt Associates are still determining which agencies will be eligible for participation in this demonstration project.
Proposed performance measures include:
- Incidence of Acute Care Hospitalization
- Incidence of Any Emergent Care
- Improvement in Bathing
- Improvement in Ambulation / Locomotion
- Improvement in Transferring
- Improvement in Urinary Incontinence
- Improvement in Management of Oral Medications
- Improvement in Status of Surgical Wounds
A similar CMS demonstration project is underway for physicians. Go to http://www.cms.hhs.gov/pqri/ to learn more about the Physician Quality Reporting Initiative.
RESOURCE SPOTLIGHT
Home Health Medications Management Toolkit
© 2002 Home Health Medications Management
This toolkit includes materials an agency needs to get started implementing the Medications Management Model, including an algorithm, model flow chart, protocols, guidelines, UR forms, and other useful tools.
Have you completed the Home Health Immunization Survey for 2007?
Please take five minutes to complete the 36 survey questions relating to your immunization practices. We are re-measuring the immunization practices in Ohio home health agencies and we need your help. The results of this survey will be compared with last year’s survey to identify trends over time.
IN THE NEWS
SET TARGETS, ACHIEVE RESULTS FOR 2007
April 16, 2007 -- Ohio KePRO -- The home health setting targets, achieving results (STAR) Web site has been updated to include the 12-month data period from 10/1/2005 - 9/30/2006.
Now is the time to return to the site to set new targets for 2007. Go to www.hhqi-star.org to log in today. Need assistance retrieving your password or using the site? Call 1.800.385.5080 and ask for a member of the Nursing Home Team.
MEASURES RELEASED FOR CMS PHYSICIAN QUALITY REPORTING INITIATIVE
April 11, 2007 -- CMS -- The Physician Quality Reporting Initiative (PQRI) establishes a financial incentive for eligible professionals to participate in a voluntary, quality reporting program. Eligible professionals who successfully report a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007, may earn a bonus payment, subject to a cap, of 1.5% of total allowed charges for covered Medicare physician fee schedule services. Read more >>
THE TOP 10 HEALTH CARE MISTAKES MADE BY THE ELDERLY
April 2, 2007 -- Elder Law Answers -- Americans are living longer than ever before, but many older Americans could better deal with their health problems, according to the Institute for Healthcare Advancement (IHA). To help the elderly stay healthier longer, the IHA has identified the 10 most common mistakes older Americans make in caring for their health. Read more >>
COMING ATTRACTIONS
SAVE THESE DATES FOR UPCOMING TELECONFERENCES:
- April 25, 2007, 1:30pm – Patient Self Management with Dr. Elizabeth Madigan
- May 1, 2007, 3:00pm – SBAR Communication with Dr Elizabeth Madigan
Stay tuned. More details to come…
