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The first constant is that change will continue as providers redesign the care delivery to meet the needs of the customer and the industry initiatives, and the second constant is that everything a provider does is interdependent and interconnected to data and outcomes of the customer experience.
Redesign of health care service delivery is rapidly occurring. While reform can be difficult for providers, there are also great opportunities.
Our approach at IHCA/INCAL is to align our members with the national initiatives of health care delivery reforms aimed at decreasing cost, reducing hospital readmissions, increasing quality and creating incentives to foster a more person-centered approach to care. Reviewing current operations for clinical and regulatory compliance performance is a critical component to remaining viable in the new health care market. We assist our members in the areas of:
The Centers for Medicare and Medicaid Services (CMS) created the Five-Star Quality Reporting and Rating System to assist consumers, facilities and caregivers to compare quality care delivery with ease. The rating features an Overall Quality Rating (1-5 Stars) and on three types of performance measures, each of which has its own five-star rating (1-5).
New Quality Measures (QMs) are added or changed frequently. In addition, new payment models use the Five-Star Quality Rating System to compare, benchmark your performance and determine reimbursement for the care and services provided. Being aware of and understanding the impact of your Five-Star Quality Rating is critical to a provider’s success.
Nursing home quality measures have four intended purposes:
The SNF VBP Program rewards skilled nursing facilities (SNFs) with incentive payments based on the quality of care they provide to Medicare beneficiaries, as measured by a hospital readmissions measure.
Under the SNF VBP Program, SNFs:
Talk to Lori Davenport at ldavenport@ihca.org to learn more.