Archive for November, 2012

Healthcare 101: Exchanges

Posted on November 28, 2012. Filed under: Government and Healthcare, HCAHPS, Post By Christy Whipple |

Each state electing to establish an Exchange must adopt the federal standards in law and rule, and have in effect a state law or regulation that implements these standards.

Again this week, the U.S. Department of Health & Human Services has extended the deadline for states to decide whether they will create and run a health insurance exchange. States have until December 14th to alert HHS if they will establish their own exchange. If so, they also must submit a blueprint for the system. This is a hot topic, but do we really understand the principles of the Exchange? This breakdown provides an overview of the key components.

Creation of Health Insurance Exchanges

Beginning on January 1, 2014 health insurance exchanges will be created where an individual or small business can compare the costs of various health plans and different types of health coverage benefits. If a state decides not to operate its own health insurance exchange, residents who are U.S. citizens and legal immigrants will be eligible to purchase a health plan from a multi-state, or regional exchange run by a government agency or a non-profit organization.

Individual State Exchanges

Each state electing to establish an Exchange must adopt the federal standards in law and rule, and have in effect a state law or regulation that implements these standards. If a state elects not to establish an Exchange, or if the HHS determines on review that state efforts to establish an Exchange have not made sufficient progress to be fully operational by January 1, 2014,  the ACA requires the Department of Health and Human Services (HHS) to establish and operate one in that state.

Qualified Health Plans (QHPs)

Exchanges should be designed to provide qualified individuals and small businesses with access to an insurers’ QHPs. QHPs are described in the ACA as a type of health plan that is subject to a specified list of requirements related to marketing, choice of providers, plan networks, essential benefits, and other features. QHP issuers will have to be licensed by each state in order to be eligible to provide coverage within their boundaries, and offer at least one QHP at the silver or gold level of coverage.

Multi-State Health Plans

Each health insurance exchange must offer at least two health plans that are available in two or more states. At least one of these health plans must be a non-profit organization and be licensed in each state. Enrollment in one of these plans would give access to healthcare services in different states.

Consumer Operated and Oriented Plan

The health reform bill will provide loans and grants to create non-profit, member-run health insurance companies known as Consumer Operated and Oriented Plans (CO-OPs).

One-Stop Shopping and Information Resource

An anticipated benefit of the health insurance exchanges is easier to purchasing and enrollment in a health plan or health coverage for employees. The health reform law recommends that states contract with “navigators” to provide information about the available health plans and to assist with enrollment.

Affordability 

If a resident cannot afford to purchase a plan in an exchange, they may be eligible for a subsidy from the government based on your income and family size. If yearly income is higher than 133% of the federal poverty level but less than 400% of the poverty level (about $43,000 for an individual), individuals will get a tax credit to help pay for health plan’s premiums and out-of-pocket expenses.


Introcomm provides custom communications solutions for the admissions and discharge processes. To learn more about how Introcomm can assist your hospital with HCAHPS, patient experience, exchanges and improving your patients’ perception of quality care (with little to no additional out of pocket expense), please contact us today to schedule our complimentary educational webinar.

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Patient Experience: Patient Perception vs Reality

Posted on November 20, 2012. Filed under: Patient Experience, Post By Christy Whipple |

Only 55% indicated that they received excellent care, despite the fact that 88% received care considered in line with the best treatment guidelines.

Christy Whipple

ImagePatients’ perceived quality of care often varies greatly from the actual quality of care (as defined by adherence to guidelines), according to a study published in the Journal of Clinical Oncology. Only 55% of women indicated that they received excellent care, despite the fact that 88% of the women surveyed received care that is considered in line with the best treatment guidelines. These findings could have huge implications for hospitals as CMS utilizes HCAHPS scores to base their reimbursement, in part, on performance and quality metrics. As described by the CMS, the HCAHPS survey is “the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.”

 

Perception Based on Interactions

Communication and interactions with medical personnel made a difference in the perception of quality among the woman surveyed. Women who reported having good communication with their physician, a clear understanding of which staff member to turn to with questions, and generally excellent treatment from the medical staff were more likely to rate their overall quality of care as excellent.

Excellent Clinical Outcomes, Poor Perception  

Effective within the last few weeks, Medicare now penalizes a hospital based on HCAHPS scores, making the success and failures of your hospital corporation heavily rely on the patients’ perception of the care hospitals provide. Your hospital and staff are clinically excellent, your outcomes good, yet your patients may perceive you as too busy to care, detached or lacking in compassion.  How can you change this perception?

Communication: The Key to Improvement

Healthcare is a relationship and communication is the cornerstone of every successful relationship. Encourage staff to communicate one-to-one with patient and family members. All staff should ask patients and families, “Is there anything else I can do for you?” before leaving a patient.  Whiteboards, rounding, shift change, proactive expectation management and discharge processes are examples of inclusive patient and family communication that raise scores.

Discharge Communication

Pamela Paxton, an analyst for iVantage Healthcare suggests a strong focus on the discharge process. “Make sure that your discharge process includes a caring and compassionate discussion of post-hospital needs… Ask and make note of patients’ questions.” Thorough instructions for post-discharge care are a necessity for patients.

 

Communication translates to Trust

Although this study examined only a sample of patients, its findings can be applicable at most institutions. The researchers conclude that healthcare organizations should improve the perceived quality of care by establishing trust between patients and healthcare staff.  Clear and detailed communication is the key factor in improving patient perceptions.


Introcomm provides custom communications solutions for the admissions and discharge processes. To learn more about HCAHPS, patient experience and improving your patients’ perception of quality care (with little to no additional out of pocket expense), please contact us today to schedule our complimentary educational webinar.

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Reduce Readmissions and Reimbursement Penalties

Posted on November 15, 2012. Filed under: Post By Christy Whipple, Readmission |

“Clearly communicate post-discharge instructions. Patient communication and education is a critical component of readmission prevention.”
Christy Whipple

Under healthcare reform, healthcare providers with high levels of preventable readmissions face the potential of losing a portion of their federal payments. The Hospital Readmissions Reduction Program, part of CMS’s Inpatient Prospective Payment System, will reduce Medicare reimbursements to hospitals with preventable 30-day readmissions; specifically acute myocardial infarction, heart failure and pneumonia. Furthermore, CMS’s Hospital Value-Based Purchasing Program includes measures for readmissions, which will also penalize hospitals for high rates of preventable readmissions. Both programs take effect fiscal year 2013. Currently, almost 20% of hospital inpatients are readmitted within as little as 30 days; for chronic conditions this figure rises to 25%.

Improved Discharge Instructions Reduce Readmission
Following recent data that discharge instructions boost patient satisfaction, comes proof that improved discharge care can reduce hospitals’ readmission rates. Thanks to a recent patient education initiative, Charleston Area Medical Center (CAMC) has seen readmission rates of heart failure and pneumonia patients fall drastically. CAMC suffered from a 24.54 percent 30 day readmission rate in the first quarter. However after implementing their initiative, in April and May of this year, only 10.64 percent of heart failure patients were readmitted to the West Virginia hospital. Additionally, the hospital saw a significant drop in the number of pneumonia readmissions from 11.11 percent to 4.4.

Chief Quality Officer of CAMC, Dale Wood, credits the success to simplifying discharge instructions. The hospital provides patients with discharge packets and handouts with important reminders, such as taking their medications, visiting their doctor within 14 days of their discharge, monitoring their weight and other important follow-up information.

Preventable Readmissions are Costly
In addition to the high costs associated with preventable readmissions, preventable readmissions rates are increasingly being used as a quality indicator by commercial payers and consumers alike. This can negatively affect hospitals’ bottom line. According to the Colorado Hospital Association, as hospitals look to cut avoidable re-hospitalizations and associated costs, more institutions are starting to amend their discharge processes.

Quality Discharge Instructions in Top 10 Proven Means of Reducing Readmissions
Becker’s Hospital Review recently released an article naming quality post-discharge instructions as one of the top 10 proven ways to reduce preventable hospital readmissions. Their findings were based on a combination of research and successful hospital initiatives. The article states, “Clearly communicate post-discharge instructions. Patient communication and education is a critical component of readmission prevention.”

 
Introcomm provides custom solutions for the admissions and discharge processes. To learn how we can decrease your hospital’s readmission rates with little to no additional out of pocket expense, please contact us today to schedule our complimentary educational webinar.
Click here to download our complimentary PDF. Learn how Introcomm can help lower readmission rates with a customizable educational marketing tool. 

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Hospital VBP: HCAHPS Insights

Posted on November 6, 2012. Filed under: HCAHPS, Post By Christy Whipple |

Patient Experience of Care Domain accounts for 30% of the Total Performance Score for 2013 and 2014
Christy Whipple

HCAHPS and VBP have likely been very popular acronyms discussed among the staff in your hospital over the past few months. Beginning with inpatients discharged in October 2012, HCAHPS performance will now account for 30 percent of the Hospital Value Based Purchasing (VBP) Total Performance Score in Fiscal Year (FY) 2013 and FY 2014. This has caused HCAHPS and VBP to become a primary focus for many hospital administrators. Most hospitals have provided trainings and lectures to prepare for this change; however a recent polling showed that 73% of hospital employees still do not have a clear understanding of the HCAHPS process. The following information is intended to provide additional insights into the latest progression of the HCAHPS process.

How is VBP Measured? The Total Performance Score for Hospital VBP in FY 2013 will have two components: the Clinical Process of Care Domain, which accounts for 70% of the Total Performance Score; and the Patient Experience of Care Domain, which accounts for 30% of the Total Performance Score.

What is the HCAHPS Survey? HCAHPS, which stands for Hospital Consumer Assessment of Health Providers and Systems, is a government survey for measuring patient satisfaction at hospitals across the country. The HCAHPS survey is the basis for the Patient Experience Domain regarding Total Performance Score for Hospital VBP. The intent of the HCAHPS initiative is to provide a standardized survey instrument and data collection methodology for measuring patients’ perspectives on hospital care.

Which Elements are Covered by the HCAHPS Survey? The following HCAHPS dimensions are used in Hospital VBP: Communication with Nurses, Communication with Doctors, Staff Responsiveness, Pain Management, Communication about Medicines, and Discharge Information, Hospital Cleanliness and Quietness, Overall Rating of Hospital.

What is the Patient Experience of Care Domain Score? The Patient Experience of Care Domain Score is the sum of the HCAHPS Base Score (0 – 80 points) and HCAHPS Consistency Points score (0 – 20 points), thus it can range from 0 to 100 points. As noted earlier, the Patient Experience Domain comprises 30% of the Hospital VBP Total Performance Score.

More information about Hospital VBP is available at the new CMS Website.

Introcomm provides custom solutions for the admissions and discharge processes which assist with each element of the HCAHPS survey. To learn how we can improve your scores with little to no additional out of pocket expense, please contact us today to schedule our complimentary educational webinar: connect@introcomm.com or www.introcomm.com/contact.aspx

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