Definitions
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)