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Customer Experience and Design

Maximizing Financial Rewards from Hospital Value Based Purchasing

Hospital payments should be based on the quality of care delivered, not the number of people treated or tests run. So says Medicare’s Hospital Value Based Purchasing Program, which has put the pressure on hospitals to perform high quality care, not just quantity of services. Medicare delivers reduced reimbursement rates and hospitals earn back this money by demonstrating performance through various measures.

For 2013, payments are determined by two sets of measures. The first set, 12 “process of care” measures, show the percentage of patients that receive the best know treatment methods as well has the time hospitals took to treat patients arriving with medical emergencies. The second set of eight measures is focused on the patient experience, which is determined by a standardized questionnaire conducted on a sample of recent patients. Medicare determines payments based not only how a hospital has performed compared to its peers, but also the level of improvement year over year.

So, how can a hospital improve the quality of care they are delivering to earn the most money back? Looking at analytics of the health data they already have is a start. Data analysis will give hospitals a clear view of their processes and financials and help them comply with Medicare’s Hospital VBP program to receive financial incentives. Providers can use the Hospital Compare Tool to see how their peers are performing and benchmark themselves against the national average – but they will need data analytics to know where they currently sit. Using analytics, hospitals are able to identify and correct processes that are inefficient, noncompliant or wasteful, which improves care and reduces costs. Not only can improving these flawed processes save the hospital money, it can also make the hospital eligible for Medicare’s financial rewards.

To learn more about value based purchasing in healthcare, join us for a webinar on May 22nd. Martin Sizemore, Director, Healthcare Strategy at Perficient, Inc. and Harshad Patil, Senior Consultant at CitiusTech, Inc., will share their perspectives on how providers can leverage advanced analytics to identify non-compliant processes and compute the prospective rewards or penalties, with a goal of continuous improvement.

To register for the webinar, click here.

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