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HCAHPS and Hospital Value-Based Purchasing (Hospital VBP) Agency for Healthcare Research and Quality Centers for Medicare and Medicaid Services June 28, 2012. Acknowledgements.
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HCAHPS and Hospital Value-Based Purchasing (Hospital VBP)Agency for Healthcare Research and QualityCenters for Medicare and Medicaid Services June 28, 2012
Acknowledgements • This Web conference program is supported by the U.S. Agency for Healthcare Research and Quality (AHRQ) through a contract with the Health Research and Educational Trust (HRET). • AHRQ is a federal agency whose mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. AHRQ is a sister agency of CMS within the U.S. Department of Health and Human Services. • HRET is a charitable and educational organization affiliated with the American Hospital Association, whose mission is to transform health care through research and education.
AHRQ/HRET Patient Safety Learning Network (PSLN) Project • AHRQ hired HRET to partner with state hospital associations and others to create 25 Patient Safety Learning Networks (PSLNs). • This year the project will provide over 30 workshops and 100 Web conferences and teleconferences to support hospitals in implementing HCAHPS, Project RED (to reduce preventable readmissions), Medication Reconciliation, AHRQ’s Quality Indicators, and the “Door to Doc” ED flow method. • We want hospitals in the 25 PSLNs to learn together and share strategies across State lines. In May we hosted a Web conference on the patient-centered discharge process, and today’s Web conference is intended to answer hospital staff’s questions about how HCAHPS fits into the VBP program.
Hospitals are Focusing on the Relationship between HCAHPS, Value-based Purchasing, and Care Transitions Top four HCAHPS Priorities of over 430 hospitals participating in 18 PSLNs: • RN Communication • Responsiveness • Medication Communication* • Discharge Information* *HCAHPS domains that can be improved by a patient-centered discharge process such as Project RED
Staff Always Explained About Medicines: U.S. Benchmarks by Type of Hospital 2010-11
Patients Given Information About Recovery At Home: U.S. Benchmarks by Type of Hospital 2010-11
Today’s Speakers • Christine Crofton, Ph.D., Center for Quality Measurement and Improvement, Agency for Healthcare Research and Quality (AHRQ) • Elizabeth Goldstein, Ph.D., Centers for Medicare and Medicaid Services (CMS)
HCAHPS and Hospital Value-Based Purchasing (Hospital VBP)Liz Goldstein, Ph.D.
HCAHPS and Hospital VBP • Hospital VBP links a portion of CMS payment to hospitals based on performance on a set of quality measures • Inpatient Prospective Payment System (IPPS) hospitals only • Established by the Patient Protection and Affordable Care Act of 2010 (Public Law 111-148) • Affects payment for patients discharged October 1, 2012 (FY 2013) and forward
Patient Experience Domain Score Sum of • HCAHPS Base Score (0 – 80 points) PLUS • HCAHPS Consistency Points (0 – 20 points) • Patient Experience Domain Score: 0 to 100 points • Comprises 30% of Hospital VBP Total Performance Score
HCAHPS and Hospital VBP Scoring • Eight HCAHPS Dimensions in Hospital VBP • Communication with Nurses • Communication with Doctors • Staff Responsiveness • Pain Management • Communication about Medicines • Discharge Information • Cleanliness & Quietness of Hospital Environment (combined) • Overall Rating of Hospital • Percent of patients who chose “Top-box” response
Hospital VBP Time Periods, FY 2013 Two time periods in Hospital VBP: FY 2013 Baseline Period: July 2009 - March 2010 FY 2013 Performance Period: July 2011 - March 2012 • IPPS hospitals must have at least 100 completed HCAHPS surveys in the Performance Period to be included in Hospital VBP
HCAHPS and Hospital VBP Scoring For each HCAHPS Dimension, both Improvement points and Achievement points are calculated Improvement Points (0-9 for each Dimension): • Amount of change from Baseline to Performance Periods Achievement Points (0-10 for each Dimension): • Difference between a Hospital’s Dimension score and the national median score • in the Performance Period
HCAHPS Base Score The first component of the Patient Experience Domain in Hospital VBP is the HCAHPS Base Score For each of the Eight HCAHPS Dimensions: • Improvement Points (0-9) and/or Achievement Points (0-10) are calculated • The larger of the Improvement Points or Achievement Points for each Dimension • Are summed to create the HCAHPS Base Score • 0 to 80 points
HCAHPS Consistency Points The second component of the Patient Experience Domain in Hospital VBP is HCAHPS Consistency Points Consistency Points • 0 to 20 points • Target hospital’s lowest performing HCAHPS Dimension • During the Performance Period
HCAHPS Consistency Points(cont’d) • If the lowest scoring Dimension is below the national median, • Then the hospital earns between 0 and 19 Consistency Points • Calculation of Consistency Points is explained thoroughly on the CMS Hospital VBP Web site
Patient Experience Domain Score Sum of • HCAHPS Base Score (0 – 80 points) PLUS • HCAHPS Consistency Points (0 – 20 points) • Patient Experience Domain Score: 0 to 100 points • Comprises 30% of Hospital VBP Total Performance Score
Base Points • Patient Experience of Care Domain Score equals (Greater of Improvement or Achievement Points for each HCAHPS dimension) plus Consistency Points • Up to 80 Base Points are possible based on each of the eight HCAHPS dimensions: • For each of the eight dimensions, determine the greater of the Achievement Points or the Improvement Points. • Add these 8 values to arrive at the total HCAHPS Base Points.
HCAHPS Consistency Points • Patient Experience of Care Domain Score equals (Greater of Improvement or Achievement Points for each dimension) plus Consistency Points • Consistency Points encourage hospitals to meet or exceed the Achievement Threshold in all HCAHPS dimensions
HCAHPS Consistency Points • Up to 20 Consistency Points may be earned based on the LOWEST dimension: • 20 points are awarded if all dimension rates are greater than or equal to the Achievement Threshold • If any dimension rate is less than the Achievement Threshold, then Consistency Points are awarded based on the lowest dimension’s location relative to the Floor
