Reading the Patient Protection and Affordability Act, it's tempting to jump to the conclusion that Medicare is the payor most interested in HCAHPS performance (for reasons discussed at length earlier).
No so.
We know of many cases where 3rd party payors are using the externally-validated, HCAHPS data, and integrating it into their payment models.
We've seen it in half a dozen states recently, and we're sure that this is the tip of the iceberg. As other payors validate the HCAHPS/Medicare experience, its a good bet that they'll integrate HCAHPS, or a similar measure into their reimbursement models, shining an even brighter light on the importance of engaging frontline associates in your HCAHPS/patient care strategy.
Showing posts with label Value-Based Purchasing. Show all posts
Showing posts with label Value-Based Purchasing. Show all posts
9/7/10
Good, bad, and surprising news regarding VBP.
By now, most people are aware of the Value-Based Purchasing provisions in the Patient Protection and Affordability Act that was signed into law last March.
The good news is that there will be financial incentives for improvement of HCAHPS scores (achievement or attainment).
The bad news is that there's no new money to pay for the incentives.
Through a somewhat complex model, most hospitals will see their base DRG reduced by 1% on October 1, 2012, to fund the incentive payments described in the legislation. This amount will increase in 2014 to 1.25%, 2015 to 1.5%, etc.
Now here's the surprise to many people: while the incentive payments begin (funded by the base DRG reductions ) in 2012, they'll actually be paying the incentives for HCAHPS performance earned in 2011.
This means that effective Oct 1, 2011, your HCAHPS scores will actually start to 'mean something', as the baseline measurement period begins. So, in less than 13 months, the HCAHPS clock really begins ticking.
It'll be more important than ever to have a coherent strategy to manage the patient experience through the involvement of every frontline associate in your building.
My challenge - questions today are:
1. How effective is your current strategy at really improving your HCAHPS scores through enhancing the patient experience?
2. Do your frontline caregivers 'own HCAHPS'?
3. Who is the executive responsible for championing changes and initiating performance improvement?
4. Where do you stand relative to your competitors - have you done a gap-analysis?
5. Have you assessed the dollars at stake for your hospital under VBP?
The good news is that there will be financial incentives for improvement of HCAHPS scores (achievement or attainment).
The bad news is that there's no new money to pay for the incentives.
Through a somewhat complex model, most hospitals will see their base DRG reduced by 1% on October 1, 2012, to fund the incentive payments described in the legislation. This amount will increase in 2014 to 1.25%, 2015 to 1.5%, etc.
Now here's the surprise to many people: while the incentive payments begin (funded by the base DRG reductions ) in 2012, they'll actually be paying the incentives for HCAHPS performance earned in 2011.
This means that effective Oct 1, 2011, your HCAHPS scores will actually start to 'mean something', as the baseline measurement period begins. So, in less than 13 months, the HCAHPS clock really begins ticking.
It'll be more important than ever to have a coherent strategy to manage the patient experience through the involvement of every frontline associate in your building.
My challenge - questions today are:
1. How effective is your current strategy at really improving your HCAHPS scores through enhancing the patient experience?
2. Do your frontline caregivers 'own HCAHPS'?
3. Who is the executive responsible for championing changes and initiating performance improvement?
4. Where do you stand relative to your competitors - have you done a gap-analysis?
5. Have you assessed the dollars at stake for your hospital under VBP?
8/31/10
Engagement, service, and sustainability.
I've been writing alot lately about how improved communication from managers can benefit the manager's direct reports as well as how this can have an impact on the collective engagement levels in an organization.
As employees become more engaged in their work, they are more likely to expend their discretionary effort in the performance of their jobs...which increases productivity.
...but what of the impact on service?
No matter how pre-defined service levels may be in an organization, by its very nature, service relies on the consistency-of-energy expenditure of the server. Low-energy expenditure, low quality of service. High-energy expenditure, higher quality of service.
At a macro level, managing service really is an exercise in managing the energy expenditure of service deliverers (regardless of the enterprise). If we assume that (nearly) every service deliverer who shows up for work is ready to expend some level of energy, the challenge for managers of service quality is to consistently maximize both effort and ability expended during a shift.
The importance of this challenge is amplified in settings where service errors can be directly quantified as lost market share, revenue, or Medicare reimbursement (as outlined in the value-based purchasing provisions under healthcare reform).
Service workers that understand their role in the organization also understand the organization's objectives, get clear task direction, consistent and frequent feedback, understand safety procedures, and have a healthy relationship with cooworkers are more likely to be involved in their job at a level approaching 'self identification'.
If your staff would say 'yes' to each of the attributes listed above, you're well on your way to enjoying the benefits of engagement, and so are your customers, as higher-than-market service scores accompany market leaders in employee engagement.
...so when you've arrived at this lofty plateau, your challenge is sustaining it!
It's not as daunting a task as it might appear, but it does require consistent focus and determination to remain in your leadership position. Regular organization-wide engagement surveys are a good way to keep this focus, and at the same time signalling to the staff that this is a priority.
Best practice is to punctuate annual surveys with periodic 'hot spot' surveys, to assure that performance improvement plans are being carried-out effectively.
As employees become more engaged in their work, they are more likely to expend their discretionary effort in the performance of their jobs...which increases productivity.
...but what of the impact on service?
No matter how pre-defined service levels may be in an organization, by its very nature, service relies on the consistency-of-energy expenditure of the server. Low-energy expenditure, low quality of service. High-energy expenditure, higher quality of service.
At a macro level, managing service really is an exercise in managing the energy expenditure of service deliverers (regardless of the enterprise). If we assume that (nearly) every service deliverer who shows up for work is ready to expend some level of energy, the challenge for managers of service quality is to consistently maximize both effort and ability expended during a shift.
The importance of this challenge is amplified in settings where service errors can be directly quantified as lost market share, revenue, or Medicare reimbursement (as outlined in the value-based purchasing provisions under healthcare reform).
Service workers that understand their role in the organization also understand the organization's objectives, get clear task direction, consistent and frequent feedback, understand safety procedures, and have a healthy relationship with cooworkers are more likely to be involved in their job at a level approaching 'self identification'.
If your staff would say 'yes' to each of the attributes listed above, you're well on your way to enjoying the benefits of engagement, and so are your customers, as higher-than-market service scores accompany market leaders in employee engagement.
...so when you've arrived at this lofty plateau, your challenge is sustaining it!
It's not as daunting a task as it might appear, but it does require consistent focus and determination to remain in your leadership position. Regular organization-wide engagement surveys are a good way to keep this focus, and at the same time signalling to the staff that this is a priority.
Best practice is to punctuate annual surveys with periodic 'hot spot' surveys, to assure that performance improvement plans are being carried-out effectively.
5/14/10
Improving the Patient Experience Through Collaborative Action Planning
Improving the patient experience is the right thing to do, on every level.
The added wrinkle is the new level of complexity soon to be presented through HCAHPS, which will introduce a financial imperative as described in the PPAC Act with Value-Based Purchasing.
While process improvements can and will make significant improvements in the patient experience (assuming that the myriad of interlocking and often complex root-causes can be isolated and systemmatically removed), there remains a critical 'missing link'...the human element.
....and it is here that almost every process improvement fails.
Let's learn from our colleagues in our other service industries who've mastered complete organizational transformation. Every single case has involved a process redesign, as well as an organization-wide, top-down/bottom-up commitment to service and solving the non-flow-able problems that routinely occur in service businesses.
If it's a people business, the transformation solution must involve the organization's people (or it will stall).
Successful organizations in the service sector (not just healthcare) make service a foundational element of the culture of the organization. It's part of the DNA of the place:
The added wrinkle is the new level of complexity soon to be presented through HCAHPS, which will introduce a financial imperative as described in the PPAC Act with Value-Based Purchasing.
While process improvements can and will make significant improvements in the patient experience (assuming that the myriad of interlocking and often complex root-causes can be isolated and systemmatically removed), there remains a critical 'missing link'...the human element.
....and it is here that almost every process improvement fails.
Let's learn from our colleagues in our other service industries who've mastered complete organizational transformation. Every single case has involved a process redesign, as well as an organization-wide, top-down/bottom-up commitment to service and solving the non-flow-able problems that routinely occur in service businesses.
If it's a people business, the transformation solution must involve the organization's people (or it will stall).
Successful organizations in the service sector (not just healthcare) make service a foundational element of the culture of the organization. It's part of the DNA of the place:
- Dissatisfaction is taken personally and resolved quickly, with deep and sincere apology
- Once the dissatisfaction is resolved, the case is reviewed, traced and every stakeholder or potential stakeholder is brought into the performance improvement team with an equal voice...to assure the situation never arises again
Other service organizations with vibrant (fanatical?) devotion to their customers implement a 'preventive' collaborative action planning process that might take the form of daily huddles that address the issues of the day, rumors, things that may cause disruption, etc. This highly effective communication process takes no more than5-10 minutes, and can serve the dual purposes of communicating news and problem avoidance.
These daily 5-10 minute huddles are:
- Inexpensive
- Amazingly effective at enhancing communication
- Excellent forums to 'get the antennae up' related to key performance indicators
- Not conducted by 99% of all service organizations
We'd be happy to share an outline of a process for this method of engaging frontline employees in problem avoidance and resolution, to create a vibrant service-driven culture that reflects in your HCAHPS performance and (very soon) in your Medicare Reimbursement under Value-Based Purchasing.
For more info, please visit us at http://www.customlearning.com/ or call us at 1800.667.7325.
5/13/10
The countdown clock has started - and this time it could cost you.
Value-based purchasing is a key component of the Patient Protection and Affordable Care Act (better known as 'The Reform Bill')...and there's stuff in there that you really need to start paying attention-to now!
Briefly, your hospital's base DRG will be reduced by 1% starting Oct 1, 2012, and accelerating in the years after that. This money goes in to a 'bonus pool' to incent hospitals to improve HCAHPS performance. Hospitals can earn-back their reduction through performance improvements measured by HCAHPS, the greater of either achievement or improvement.
It's a complex formula, that I'd be happy to share with you, and model your hospital for you.
Here's what you need to pay attention to now:
1. The benchmarking period begins Oct 1, 2011. This is when your HCAHPS scores 'start meaning something', and will factor into the equation that determines your Medicare Reimbursement in 2012.
2. You can calculate the cost of your performance (in Medicare Reimbursement dollars) by HCAHPS dimension. This will allow you to develop a meaningful, prioritize plan that links operations and patient experience directly to your bottom line.
3. There are elements in the Legislation that make HCAHPS-VBP a bit of a moving target yet. The more performance improvement initiatives that you have effectively in place now, the more engaged and collaborative your staff are in the process of improvement, the stronger you'll be in just a few months down the road.
4. The financial impact can be very significant.
Give me a call at 403.607.7444 or email me directly at brian@customlearning.com, and I'll present a customized VBP assessment to you.
Briefly, your hospital's base DRG will be reduced by 1% starting Oct 1, 2012, and accelerating in the years after that. This money goes in to a 'bonus pool' to incent hospitals to improve HCAHPS performance. Hospitals can earn-back their reduction through performance improvements measured by HCAHPS, the greater of either achievement or improvement.
It's a complex formula, that I'd be happy to share with you, and model your hospital for you.
Here's what you need to pay attention to now:
1. The benchmarking period begins Oct 1, 2011. This is when your HCAHPS scores 'start meaning something', and will factor into the equation that determines your Medicare Reimbursement in 2012.
2. You can calculate the cost of your performance (in Medicare Reimbursement dollars) by HCAHPS dimension. This will allow you to develop a meaningful, prioritize plan that links operations and patient experience directly to your bottom line.
3. There are elements in the Legislation that make HCAHPS-VBP a bit of a moving target yet. The more performance improvement initiatives that you have effectively in place now, the more engaged and collaborative your staff are in the process of improvement, the stronger you'll be in just a few months down the road.
4. The financial impact can be very significant.
Give me a call at 403.607.7444 or email me directly at brian@customlearning.com, and I'll present a customized VBP assessment to you.
5/5/10
Are you an 'inspirer'?
Sylvia Ann Hewlett, an economist and the founding president of the Center for Work-Life Policy blogs that "Leaders who still believe that inspiring employees should take a backseat to cost-cutting need to look to Apple."
She gives a few examples of inspiring leaders in her article, that, while not necessarily relevant in a hospital setting, are certainly enough to get us thinking outside of the box.
I'm writing to you today on the topic of inspiration, because it's my belief that without an inspired workforce, you're dead in the water. With HCAHPS value-based purchasing looming on the horizon, an inspired workforce that's focused on delivering outstanding service has never been more important.
I strongly urge all Administrators, PI Directors, CNO's, Service Excellence councils and others involved in HCAHPS management to seize the remaining few months before VBP kicks-in, to instill a culture that is fanatical about the patient experience (before it adversely affects your Medicare reimbursement).
One of the most inspirational activities that a manager can schedule is attending the Healthcare Service Excellence Conference. The 11th Annual event will be held January 26-28, 2011 in New Orleans. While details will follow shortly, I urge you to save this date and plan to attend this important event that for the last 5 years has scored 98% in Delegate Satisfaction.
She gives a few examples of inspiring leaders in her article, that, while not necessarily relevant in a hospital setting, are certainly enough to get us thinking outside of the box.
I'm writing to you today on the topic of inspiration, because it's my belief that without an inspired workforce, you're dead in the water. With HCAHPS value-based purchasing looming on the horizon, an inspired workforce that's focused on delivering outstanding service has never been more important.
I strongly urge all Administrators, PI Directors, CNO's, Service Excellence councils and others involved in HCAHPS management to seize the remaining few months before VBP kicks-in, to instill a culture that is fanatical about the patient experience (before it adversely affects your Medicare reimbursement).
One of the most inspirational activities that a manager can schedule is attending the Healthcare Service Excellence Conference. The 11th Annual event will be held January 26-28, 2011 in New Orleans. While details will follow shortly, I urge you to save this date and plan to attend this important event that for the last 5 years has scored 98% in Delegate Satisfaction.
SVEHMAAMYRQP
10/15/09
The Leadership Factor in Value-Based Purchasing
The countdown is on to the Healthcare Service Excellence Conference!
With relentless pressures such as present on admission (POA), recovery audit contractors (RAC), hospital acquired conditions (HAC), payment for performance (P4P), HCAHPS, Never Events and Core Measures, hospitals have a new urgency to understand how to thrive in a value-based purchasing environment.
While many hospitals have approached these initiatives as discrete and unrelated, connecting the dots between these initiatives reveals the urgency (and the opportunity) of VBP.
The Healthcare Service Excellence Conference has focused this year's agenda on Value-Based Purchasing to help navigate through the complexity.
It is a must attend for any healthcare professional.
Sessions of Interest:
The Leadership Factor in Value-Based Purchasing
Hospital of Choice 2010
Improving HCAHPS Results on a Unit-Level Basis
There's much more to this dynamic event, that I firmly believe that every hospital should send at least one leader!
Call me directly for more info (403-607-7444), or visit http://www.healthcareserviceexcellence.com to register.
Brian.
With relentless pressures such as present on admission (POA), recovery audit contractors (RAC), hospital acquired conditions (HAC), payment for performance (P4P), HCAHPS, Never Events and Core Measures, hospitals have a new urgency to understand how to thrive in a value-based purchasing environment.
While many hospitals have approached these initiatives as discrete and unrelated, connecting the dots between these initiatives reveals the urgency (and the opportunity) of VBP.
The Healthcare Service Excellence Conference has focused this year's agenda on Value-Based Purchasing to help navigate through the complexity.
It is a must attend for any healthcare professional.
Sessions of Interest:
The Leadership Factor in Value-Based Purchasing
Hospital of Choice 2010
Improving HCAHPS Results on a Unit-Level Basis
There's much more to this dynamic event, that I firmly believe that every hospital should send at least one leader!
Call me directly for more info (403-607-7444), or visit http://www.healthcareserviceexcellence.com to register.
Brian.
8/21/08
The Healthcare Service Excellence Conference - now more than ever?
As 'pay for reporting' inevitably gives way to 'pay for performance', the time to architect an aggressive HCAHPS score-movement strategy has never been more urgent. To that end, I'm proud to announce that the Healthcare Service Excellence Conference is coming around again (November 5-7, 2008, in Louisville - see the links below to register!).
The event is a 'combustible' gathering of service excellence pros from across the US...it's really quite inspiring. As this'll be my 9th year attending (I'm keynoting this year), I thought I'd share with you:
The 10 Reasons why the Healthcare Service Excellence Conference
truly is a 'Can't Miss' event for hospital leaders:
1. Create a positive impact on your HCAHPS scores
2. Develop appropriate standards to address disruptive Physician behaviors and staff perceptions
3. Implement accountability systems that will reinforce and sustain peak performance
4. Learn what's likely to come when value-based purchasing becomes a reality...and what you can be doing about it now
5. Drive strategic change through focused/invigorated leadership
6. Connect your team with the most vibrant online community of service excellence professionals, dedicated to solving problems and maximizing the patient experience (a community-style peer-to-peer best practices resource is being launched at the conference)
7. View new technologies that enable constant improvement in the patient experience, through dramatic increases in accountability and early-warning of negative trends.
8. Learn strategies to address and tie physician disruptive behaviors to improvements in clinical and satisfaction outcomes.
9. Challenge and learn from peers and experts from survey firms to learn the latest thinking, strategies, and best practices in the HCAHPS roundtables.
10. Learn how rapid cycle process improvement can impact your hospital, while producing sustained results.
...see you in Louisville November 5-7? B
The event is a 'combustible' gathering of service excellence pros from across the US...it's really quite inspiring. As this'll be my 9th year attending (I'm keynoting this year), I thought I'd share with you:
The 10 Reasons why the Healthcare Service Excellence Conference
truly is a 'Can't Miss' event for hospital leaders:
1. Create a positive impact on your HCAHPS scores
2. Develop appropriate standards to address disruptive Physician behaviors and staff perceptions
3. Implement accountability systems that will reinforce and sustain peak performance
4. Learn what's likely to come when value-based purchasing becomes a reality...and what you can be doing about it now
5. Drive strategic change through focused/invigorated leadership
6. Connect your team with the most vibrant online community of service excellence professionals, dedicated to solving problems and maximizing the patient experience (a community-style peer-to-peer best practices resource is being launched at the conference)
7. View new technologies that enable constant improvement in the patient experience, through dramatic increases in accountability and early-warning of negative trends.
8. Learn strategies to address and tie physician disruptive behaviors to improvements in clinical and satisfaction outcomes.
9. Challenge and learn from peers and experts from survey firms to learn the latest thinking, strategies, and best practices in the HCAHPS roundtables.
10. Learn how rapid cycle process improvement can impact your hospital, while producing sustained results.
...see you in Louisville November 5-7? B
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