Archive for the ‘Healthcare Quality Ratings’ Category

Guest Post: Increase HCAHPS Scores Through Healthcare Design

July 10th, 2018 by Rebecca Donner

Improving HCAHPS scores from an interior design perspective.

The Centers for Medicare & Medicaid Services’ (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was established as a way to measure patients’ perspectives on healthcare and make comparisons across hospitals based on the patient experience. Receiving a high score can boost hospitals’ Medicare/Medicaid reimbursement, while a low score can decrease funding by as much as 2 percent. Because HCAHPS scores can affect a hospital’s bottom line, it provides an incentive for them to place a greater focus on patient experience to receive a high score.

There a number of ways to increase a HCAHPS score, including patient communication and respect, speediness, cleanliness and even pain management procedures. But one way that may be overlooked is how to raise that score through interior design. There are a number of ways to approach HCAHPS scores from a design perspective.

Noise Reduction

With so much commotion in hospitals, it can be difficult for patients to rest, which is a key component to the healing process. Standard noise levels should be 35 dB(A) during the day and 30 d(B)A at night, but peak noise levels in hospitals often exceed 85 to 90 db(A), according to the Center for Health Design.

Aside from limiting overhead announcements and machine beeping, hospitals can reduce noise by focusing on the materials they use inside their facility. Carpet tiles or rubber flooring, as opposed to tile, can reduce the noise of foot traffic outside patient rooms. In addition, acoustic wall coverings and ceiling tiles act as giant sonic sponges, soaking up unwanted noise and echo. This can prevent any loud conversations or unwanted noises from traveling down hallways.

Privacy

Privacy and comfort rank high in ways to improve patient experience. According to the 2016 Hospital Construction Survey, many hospitals are now converting semi-private rooms into private rooms to increase patient privacy. After all, no one wants to share a room with a stranger during what can be one of the scariest times in someone’s life. Plus, two patients in a room can increase the chance of infection.

Many hospitals are also increasing the square footage of patient rooms. This way, even if two patients are sharing a room, they each have plenty of private space.

Personal Controls

To make the hospital feel like home as much as possible, many facilities are now offering patients greater control over the lighting, temperature and window shades in their rooms. Everyone has different preferences when it comes to how warm or cool, or how dark or bright, they want a room to be. Personal dimming controls allow patients to adjust the lighting depending on their activity, whether they are trying to sleep or need extra light for reading or examinations. Giving patients control over these variables can lead to higher patient satisfaction.

Mobility

Hospitals with high mobility and accessibility receive higher HCAHPS scores. Installing handrails makes it easier for patients to get to the bathroom, and wide bathrooms give patients the space they need when using the facilities.

About the Author:

Rebecca Donner

Rebecca Donner

Rebecca Donner is the owner and founder of Nashville-based healthcare interior design firm Inner Design Studio. For more information.

Infographic: Shooting for Five Stars in Medicare Advantage

May 28th, 2018 by Melanie Matthews

Health plans have continued to mature in their approach to the Centers for Medicare and Medicaid Services’ Stars rating. Over the past two years, they have become more effective and more efficient at driving high quality scores overall, demonstrated by significant increases in the 4-Star thresholds of key measures, according to a new infographic by Oliver Wyman.

The infographic provides an analysis of annual Stars metrics, which demonstrates a continued high correlation between plans’ overall Stars scores and their performance on provider-driven measures.

2018 Healthcare Benchmarks: Telehealth & Remote Patient MonitoringArtificial intelligence. Automation. Blockchain. Robotics. Once the domain of science fiction, these telehealth technologies have begun to transform the fabric of healthcare delivery systems. As further proof of telehealth’s explosive growth, the use of wearable health-tracking devices and remote patient monitoring has proliferated, and the Centers for Medicare and Medicaid Services (CMS) has added several new provider telehealth billing codes for calendar year 2018.

2018 Healthcare Benchmarks: Telehealth & Remote Patient Monitoring delivers the latest actionable telehealth and remote patient monitoring metrics on tools, applications, challenges, successes and ROI from healthcare organizations across the care spectrum. This 60-page report, now in its fifth edition, documents benchmarks on current and planned telehealth and remote patient monitoring initiatives as well as the use of emerging technologies in the healthcare space.

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Infographic: How Does CMS’ New Methodology Impact Hospital Star Ratings?

February 5th, 2018 by Melanie Matthews

The number of hospitals that received the highest possible overall rating increased from 83 in December 2016 to 337 in December 2017 under CMS’ new methodology, according to a new infographic by Stroudwater Associates.

The infographic examines 11 HCAPHS questions for a select group of hospitals and compares them against the selected peers and national benchmarks.

Healthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare IndustryHealthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare Industry, HIN’s 14th annual business forecast, is designed to support healthcare C-suite planning as leaders react to presidential priorities and seek new strategies for engaging providers, patients and health plan members in value-based care.

HIN’s highly anticipated annual strategic playbook opens with perspectives from industry thought leader Brian Sanderson, managing principal, healthcare services, Crowe Horwath, who outlines a roadmap to healthcare provider success by examining the key issues, challenges and opportunities facing providers in the year to come. Following Sanderson’s outlook is guidance for healthcare payors from David Buchanan, president, Buchanan Strategies, on navigating seven hot button areas for insurers, from the future of Obamacare to the changing face of telehealth to the surprising role grocery stores might one day play in healthcare delivery. Click here for more information.

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In Successful ACOs, Population Health Focus Paves Way for Shared Savings Payouts

January 25th, 2018 by Patricia Donovan

Physician practices toiling in fledgling ACOs and obsessing over shared savings that have not yet materialized, take heart: population health offers multiple revenue streams for accountable care organizations waiting for the “gravy” of accountable care.

“Gravy” is the way Tim Gronniger, senior vice president of development and strategy for Caravan Health, refers to ACO shared savings payouts, which he says can take considerable time to accrue.

“It is literally two years from the time you jump into an ACO before you have even the chance of a shared savings payout,” Gronniger told participants in Generating Population Health Revenue: ACO Best Practices for Medicare Shared Savings and MIPS Success, a January 2018 webcast now available for replay.

Obsessing over shared savings is one of the biggest mistakes hospitals in ACOs can make, he added.

This delay is one reason Caravan Health urges its ACOs to adopt a population health focus, whether pursuing the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) or the Medicare Shared Savings Program (MSSP).

Gronniger’s advice is predicated on his organization’s experience of mentoring 38 ACOs. In 2016, Caravan Health’s ACOs saved more than $26 million in the MSSP program and achieved higher than average quality scores and quality reporting scores, according to recently released CMS data.

Walking attendees through a MACRA primer, Gronniger underscored the challenges of the MIPS program, one of three tracks offered under the Quality Payment Program. “Barring a really exceptional performance on MIPS, you can’t even break even over the next few years on physician compensation,” he said.

In the meantime, ACOs should utilize recently rolled out Medicare billing codes, from the annual wellness visit (AWV) to advanced care planning, to generate wellness revenue. With proper planning, reengineering of staffing and clinical work flows, a practice could generate anywhere from five hundred to one thousand dollars annually per eligible Medicare patient, Gronniger estimates—monies that offset the cost of constructing a sustainable ACO business model.

To back up this population health rationale, Gronniger pointed to data from an ACO client demonstrating the impact of a cohesive PHM approach, including the use of trained population health nurses, on completion rates for preventive screenings. For less top-of-mind screenings like falls assessment and smoking cessation, completion rates rose from negligible to near-universal levels, he said.

“These are recommended sets of screens that are required by CMS, but that also help ACOs with quality measures,” he added.

Gronniger also shared examples of dashboards, scorecards and roadmaps Caravan Health employs to help keep client ACOs on track. An ACO success strategy involves “a lot of dashboarding, checking in, and discussion of problems and barriers, discussion of solutions, and monthly and quarterly measurement and reporting back,” he said.

Beyond coveted shared savings, ACO participation offers significant non-financial benefits, including quality improvements under both MSSP and MIPS standards, availability of ACO-specific waivers, and access to proprietary performance data.

Overall, ACO participation can make providers more attractive both to commercial contractors and to potential patients perusing Physician Compare ratings in greater numbers.

Gronniger ended by weighing in on the recent recommendation by the Medicare Payment Advisory Commission (MedPAC) to repeal and replace the MIPS program.

Assessing MIPS’ Fate: “MedPAC Vote Would Not Affect 2018 Under Any Scenario”

January 18th, 2018 by Patricia Donovan

Tim Gronniger

Tim Gronniger, Senior VP of Development and Strategy, Caravan Health

Amidst healthcare provider outcry over last week’s vote by the Medicare Payment Advisory Commission (MedPAC) to repeal and replace the Merit-based Incentive Payment System (MIPS), an industry thought leader sought to remind physician groups that no change to MIPS is imminent.

“MedPAC is an advisory body, not a legislative one,” said Tim Gronniger, senior vice president of development and strategy for Caravan Health, a provider solutions for healthcare organizations interested in value-based payment models, including accountable care organizations (ACOs).

“Congress would need to adopt MedPAC’s recommendations in order for the changes to go into effect. It is reasonable to expect MIPS to evolve over time, but that evolution will be gradual. [MedPAC’s vote on MIPS] would not affect 2018 under any scenario.”

Gronniger made his comments during Generating Population Health Revenue: ACO Best Practices for Medicare Shared Savings and MIPS Success, a January 2018 webcast sponsored by the Healthcare Intelligence Network and now available for rebroadcast.

Earlier this month, MedPAC voted 14-2 to scrap the MIPS program, describing it in a presentation to members as “burdensome and complex.” According to the advisory commission, “MIPS will not succeed in helping beneficiaries choose clinicians, helping clinicians change practice patterns to improve value, or helping the Medicare program to reward clinicians based on value.”

MedPAC is expected to pass this recommendation along to Congress in coming months, along with a proposed alternative. In MIPS’s place, MedPAC is suggesting a voluntary value program (VVP) in which “group performance will be assessed using uniform population-based measures in the categories of clinical quality, patient experience, and value.”

MGMA’s Anders Gilberg reacts to the MedPAC ruling.

Among the provider groups reacting to MedPAC’s actions was the Medical Group Management Association (MGMA). In a Twitter post, Anders Gilberg, MGMA’s senior vice president for government affairs, called the VVP alternative “a poor replacement,” claiming it “would conscript physician groups into virtual groups and grade them on broad claims-based measures.”

The day prior to the January 11 vote, MGMA had reached out in a letter to Seema Verma, administrator for the Centers for Medicare & Medicaid Services (CMS), requesting CMS to immediately release 2018 Merit-based Incentive Payment System (MIPS) eligibility information, which it called “vital to the complex clinical and administrative coordination necessary to participate in MIPS.”

Infographic: How Engaged Healthcare Employees Cultivate a Positive Patient Experience

August 14th, 2017 by Melanie Matthews

Excellent clinical care is only one part of a great patient experience, especially considering the limited amount of time doctors spend with patients. All staff members with whom patients come into contact must be aligned in their commitment to patients’ comfort, care, and peace of mind. By establishing core values and standards of behavior and recognizing those who embody them, hospital administrators can positively affect all patient touchpoints within their facility, according to a new infographic by WorkStride.

The infographic examines the characteristics of an engaged healthcare employee and what healthcare organizations can do to increase patient satisfaction within their organization.

UnityPoint Health has moved from a siloed approach to improving the patient experience at each of its locations to a system-wide approach that encompasses a consistent, baseline experience while still allowing for each institution to address its specific needs.

Armed with data from its Press Ganey and CAHPS® Hospital Survey scores, UnityPoint’s patient experience team developed a front-line staff-driven improvement action plan.

Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action Plan, a 45-minute webinar on July 27th, now available for replay, Paige Moore, director, patient experience at UnityPoint Health—Des Moines, shares how the organization switched from a top-down, leadership-driven patient experience improvement approach to one that engages front-line staff to own the process.

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Service Action Teams Turn Front-Line Staff into Patient Experience Ambassadors

August 8th, 2017 by Patricia Donovan
Patient Experience

Increasingly, patient satisfaction scores figure into payors’ healthcare reimbursement formulas.

UnityPoint Health is so invested in the concept of patient experience that it charges each member of its organization, whether healthcare provider or not, with a set of basic behaviors designed to improve it.

These four foundational behaviors, rooted in courtesy and common sense, drive the manner in which patients, families and visitors are greeted and assisted at all times.

“We know there are dozens of initiatives and tactics that can be used to help improve patient experience,” said Paige Moore, director of patient experience at UnityPoint Health-Des Moines, “But the four we chose were driven by patient and visitor comments and feedback.”

Ms. Moore shared these behaviors, as well as an inside look at her organization’s patient experience improvement plan, during Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action Plan, a July 2017 webinar now available in on-demand and training formats.

Having established this system-wide coda for all employees, UnityPoint Health next looked at further enlisting its frontline staff in efforts to improve the patient experience. To do so, it created a set of seven service action teams, with two more in the works.

Each service action team is composed of at least 50 percent of that department’s frontline staff, rounded out by an executive sponsor and team lead.

“We want all of our team members to be actively engaged in the projects, to take responsibility for them, to be ambassadors and patient experience champions throughout the organization,” explained Ms. Moore.

Each team reviews results from HCAHPS® and Press Ganey® patient experience surveys to identify department priorities, such as nurses’ narration of care, physicians’ use of clear language, or discharge or transfer processes.

UnityPoint Health launched its first service action team in 2014 for outpatient services. “This was our largest volume for surveys and it also had some of our lowest patient experience performance. We really wanted to get in and see what could we do to make the biggest impact on the highest number of our patients.”

Once that team developed some tactics to improve patient privacy concerns, wait times and registration processes, it saw improvements in those areas.

During the program, Ms. Moore outlined priorities and shared results from each service action team.

Importantly, there are two support service action teams: a measurements team to educate employees on the relevance of patient experience scores and their role in them, and a communications team to convey information on patient experience activities throughout UnityPoint Health. The health system also recently launched an “Excellence in Patient Experience” awards program.

And rounding out the program is the placement of patient experience directors like Ms. Moore throughout the organization, each supported by a physician champion.

Physician education in patient experience is ongoing, she added, whether during rounds or mandatory one-on-one shadowing and coaching for patient experience for all new hires.

Listen to an interview with Paige Moore on UnityPointHealth’s four foundational behaviors.

Shared SNF Patients, Common Readmissions Goals Unify Three Competing Health Systems

June 15th, 2017 by Patricia Donovan

A common desire to reduce SNF readmissions resulted in the formation of Michigan's Tri-County SNF Collaborative.

A common desire to reduce SNF readmissions resulted in the formation of Michigan’s Tri-County SNF Collaborative.

Concerned about escalating hospital readmissions from skilled nursing facilities (SNFs) and the accompanying pinch of Medicare readmissions penalties, three Michigan healthcare organizations decided to set competition aside to collaborate and reduce rehospitalizations from SNFs. Here, Susan Craft, director of care coordination, family caregiver program, Office of Clinical Quality & Safety at Henry Ford Health System, describes the origins of Michigan’s Tri-County SNF Collaborative, of which her organization is a founding member.

I want to talk about the formation of the Tri-County SNF Collaborative between Henry Ford Health System, Detroit Medical Center, and St. John Providence Health System. As quality and care transition leaders from each of the health systems, we see each other frequently at various meetings. After some good conversation, we learned that each of us was partnering with our SNFs to improve quality and reduce readmissions.

We all required that they submit data to us that was very similar in nature but not exactly the same, which created a lot of burden for our SNFs to conform to multiple reporting requirements. We knew we were working with the same facilities because geographically, we are all very close to each other. We recognized that this was really a community problem, and not an individual hospital problem. Although we are all competing healthcare systems, those of us with very similar roles in the organization had very little risk from working together. And because we had so much in common, it just made sense that we create this collaborative.

We also worked with our MPRO (Michigan Quality Improvement Organization) and reviewed data that showed that about 30 percent of our patient population was shared between our three health systems. We decided it made sense to move forward. We created a partnership that was based on collaboration and transparency, even within our health systems. We identified common metrics to be used by all of our organizations and agreed upon operational definitions for each of those. We all reached out to our SNF partners to tell them about the collaborative and invite them to join, and then engaged MPRO as our objective third party. We created a charter to solidify that cooperation and collaboration.

Source: A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics

reducing SNF readmissions

A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics examines the evolution of the Tri-County SNF Collaborative, as well as the set of clinical and quality targets and metrics with which it operates.

Reducing SNF Readmissions: Clinical Targets, Quality Scorecards Elevate Performance

May 23rd, 2017 by Patricia Donovan

reducing SNF readmissions

Michigan’s Tri-County Collaborative holds the line on hospital readmissions from 130 participating SNFs.

Three geographically close Michigan health systems shared more than a concern over escalating readmissions from skilled nursing facilities (SNFs).

As Henry Ford Health System (HFHS), the Detroit Medical Center and St. John’s Providence Health System ultimately discovered from Michigan Quality Improvement Organization (MPRO) data in 2013, they also shared about 30 percent of their patient population.

This revelation, combined with the pinch of new hospital readmission penalties from the Centers for Medicare and Medicaid Services (CMS), prompted the three to set aside competition and siloed strategies and forge a coordinated approach to reducing readmissions from SNFs.

Today, the resulting Tri-County SNF Collaborative operates with a set of clinical and quality targets and metrics created in tandem with more than 130 member SNFs. Tri-County’s dozen participation requirements for SNFs range from regular reporting through a dedicated SNF portal to achievement of specified performance metrics.

“We developed collaborative relationships,” explained Susan Craft, director of care coordination for the family caregiver program in HFHS’s Office of Clinical Quality & Safety. “We wanted to have very open, honest conversations to review issues that were identified and find ways to resolve those.”

Ms. Craft shared the roots, framework and results of the SNF collaborative, which launched in the first quarter of 2015, during Reducing SNF Readmissions: Quality Reporting Metrics Drive Improvements, a May 2017 webcast now available for replay.

Once admitted to the collaborative, member SNFs must report on 14 metrics in four key areas: acuity, care transitions, quality and readmissions. In return, SNFs receive a 13-point unblinded quarterly scorecard with metrics on readmissions and patient acceptance response times, among many others.

A multidisciplinary team within Tri-County Collaborative reviews all SNF metrics bi-annually to determine each facility’s continued participation.

As for the collaborative’s impact since its launch, Henry Ford Health System achieved a nearly 20 percent drop in Medicare SNF readmissions as well as a 28 percent reduction in SNF lengths of stay. The initiative also identified opportunities for improvement, resulting in enhanced outpatient scheduling and nurse-to-nurse handoffs and interventions focused on SNF-specific issues like sepsis, Ms. Craft explained.

Despite these advancements, the collaborative still faces the inherent challenges of competition and transparency, as well as SNFs’ hesitancy to adopt value-based practices. “Our SNFs are still entirely dependent on fee for service [payment models],” said Craft. “They haven’t been impacted by penalties and value-based purchasing, although that is coming for them next year.”

Although not yet referring to participating SNFs as “preferred providers,” the collaboratives hopes to one day equip patients with complete data pictures to guide them in SNF selection. Also on Tri-County Collaborative’s radar are home care agencies, concluded Ms. Craft.

“We know there needs to be a lot of coordination across all post-acute care settings.”

Listen to Susan Craft describe how Michigan’s SNF Collaborative set aside competition to improve quality and readmission rates.

Infographic: Patient Wait Time Trends

March 27th, 2017 by Melanie Matthews

Patients are spending less time waiting to see a doctor compared to six years ago, according to a new infographic by Vitals.

The infographic examines what has lead to decreased wait times, the effect of wait times on physician ratings and cities with the shortest and longest wait times.

Patient-centric interventions like population health management, health coaching, home visits and telephonic outreach are designed to engage individuals in health self-management—contributing to healthier clinical and financial results in healthcare’s value-based reimbursement climate.

But when organizations consistently rank patient engagement as their most critical care challenge, as hundreds have in response to HIN benchmark surveys, which strategies will help to bring about the desired health behavior change in high-risk populations?

9 Protocols to Promote Patient Engagement in High-Risk, High-Cost Populations presents a collection of tactics that are successfully activating the most resistant, hard-to-engage patients and health plan members in chronic condition management. Whether an organization refers to this population segment as high-risk, high-cost, clinically complex, high-utilizer or simply top-of-the-pyramid ‘VIPs,’ the touch points and technologies in this resource will recharge their care coordination approach.

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