Question

compare and contrast two of CMS's value-based purchasing programs.

Answer 1

Ans) 1. Aspirin at discharge for Acute Myocardial Infarction
2. Discharge instructions for heart failure patients
3. Blood culture performed in the ED prior to initial antibiotic received in hospital for pneumonia cases
4. Venous thromboembolism prophylaxis ordered for surgeries

CMS evaluates the conditions:
Improvement score
Based on their current performance compared to their baseline

Achievement score
Based on their performance compared with all hospitals

2014 CMS withheld:
CMS withheld more than 1.1 billion dollars to redistribute as incentives

Hospitalists:
Hospital may increase hospitalists numbers
Critical to improve hospital performance
On site physician monitoring
Maintaining high quality care during hospital stays

Coordinated Care:
Rewards coordination of care between
Physicians
Caregivers
Hospital departments
Community Providers
Healthcare Institutions

Value Based Purchasing Idealized:
Improved Quality
Increase Process Metrics
Expand to more outcome metrics
Tempered Decrease in Costs
Measurable Improvement
Cost
Quality