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Idiot’s Guide to CMS, VBP, HCAHPs, CPC, TPS

Idiot’s Guide to CMS, VBP, HCAHPs, CPC, TPS. Or, why can’t I just practice good clinical medicine and have all of you figure out this BS?. $ urvival. At Risk: significant revenue to our hospital based on measures over which we have little: Awareness C ontrol over the measuring process

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Idiot’s Guide to CMS, VBP, HCAHPs, CPC, TPS

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  1. Idiot’s Guide to CMS, VBP, HCAHPs, CPC, TPS Or, why can’t I just practice good clinical medicine and have all of you figure out this BS?

  2. $urvival • At 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.

  3. Simple Definitions • CMS = Center for Medicare/Medicaid Services • VBP = Value Based Purchasing • HCAHPs = Scores based on random surveys of patients recently hospitalized • CPCs = Clinical Processes of Care • Outcomes Domain Measure (ODM) • TPS = Total Performance Score TPS = HCAHPs + CPCs + ODM (30%) (40%) (30%)

  4. WHAT SHOULD YOU ASK YOURSELF? When? Why? How? Where? Can I help?

  5. Time Frames:Performance is not Predictable in a Chaotic System

  6. HCAHPS SCORES

  7. CPC Achievement & Benchmarks

  8. Outcomes Achievement & Benchmarks

  9. 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 ccLink Disgruntled staff pissed off about not having a summer vacation Denis Maharcame 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 2012 Outcomes Measures – July 2011 to June 2012

  10. How Do We Reverse This? As Medical Staff Leaders, We Need To: • Understand the process • Understand the measures • Understand how to accurately interpret and communicate this process & measures to our staff members • Take responsibility for the measures that are the outcomes of our departments • Demand accountability from ourselves; our quality/administrative leaders; our colleagues and our Board

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