Pay-for-perfomance
Hospitals reimbursed based on performance
Value-Based Purchasing, Reasmissions, hospital acquired conditions
3 Major Pay-for-performance Programs
Value based purchasing
Hospitals can receive a financial bonus for strong performance
Clinical Care Outcomes, Patient Experience, Efficiency, Safety, Clinical care
process (Core Measures)
5 Domains of Value Based Purchasing
Mortality
Clinical care outcomes places a heavy emphasis on _________.
MSPB (Medicare Spending per Beficiary
Term for how Medicare determines a hospitals Efficiency
3 days prior to admission to 30 days post discharge.
MSBP (Medicare Spending per Beneficiary) comprises the cost of care from what time
frame?
Patient Safety Indicators (PSIs) and infection rates
Medicare measures safety using _________.
A tool that can measure Readmission risk
Society for Hospital Medicines Project Boost Risk Assessment (8Ps)
Society for Hospital Medicines Project Boost Risk Assessment (8Ps)- Measures
Readmission Risk
8Ps is
A tool that can measure Readmission risk
The LACE Index is ________.
A tool that can measure Readmission risk
AHRQ Project Red Toolbox
severity of illness, identify factors that put the pt at higher risk for readmission.
Readmission risk tools assess are _____?
Identifying pt/family goals, determine expected level of care (input v outpt),
identify appropriate post-acute options (allowing to get auth before procedure)
Preadmission assessment includes
Past medical History, Family History, Medications, Recent
hospitalizations/surgeries, identify patient goals, Presence of advance directive,
identification of next of kin, Durable POA, current living situation, Details
regarding language and learning style, Preferred DC destination
Nursing admission assessment includes
the degree to chick pts have capacity to obtain, process and understand basic
health info and services needed to make health decisions
Teach-back or having pt read something and then explain to you
Assess Health Literacy by______
Title VI of the Civil Rights act added in 1980
Law that medicare and medicaid cannot discriminated based on LEP (limited English
proficiency)