In healthcare, transparency refers to the availability of information about the quality and cost of healthcare, allowing consumers to choose a healthcare provider based on value. Increasingly, consumers are taking an active role in directing their own healthcare. Increased transparency is a theme of healthcare reform, and changes are on the horizon for LTPAC providers.
On July 19, 2012, CMS will launch updates to the Nursing Home Compare website, including a significant amount of new information: new quality measures based on MDS 3.0 data (finally!), detailed inspection (survey) reports, ownership information and enhanced staffing information (including physical therapy hours per resident day).
Your outcomes are being measured, monitored and reported – so who will be looking at them? Who are the “consumers” of skilled nursing facility services? Residents are certainly consumers, but are they accessing the Nursing Home Compare website? According to Nielson, more people than ever over age 65 are using the internet, and it is the fastest growing age group for internet usage. Even if residents (or prospective residents) are not accessing the site directly, it is likely that their children are – and family members play a significant role in selecting healthcare options for seniors.
Payers are also consumers of healthcare. Medicare “value-based purchasing,” which is in demonstration projects now, is likely to become the norm in the next few years, as we know that Medicare fee-for-service is unsustainable. We’re hearing from providers that some managed care companies are now cancelling their contracts with SNFs due to what they consider to be poor outcomes for their members – based on their claims data as well as publicly-reported information on Nursing Home Compare.
And don’t you think your competition is looking at your outcomes? Are you looking at your competition’s outcomes?
What you can do to take action:
- Improve your quality measures by improving clinical outcomes. Implement current evidence-based practice and standards of care for common conditions and chronic diseases in seniors, such as pressure ulcer and fall prevention and treatment, urinary tract infection, pneumonia, diabetes, COPD and heart failure.
- Ensure that your MDS 3.0 data is accurate, as quality measures are based on it. Hire and retain qualified and competent MDS nurses, provide ongoing education to your interdisciplinary team, perform coding audits, and consider using pre-submission accuracy and validity check software.
- Ensure that the information you provide during survey on staffing and census is correct. Many providers fill out the CMS-671 and CMS-672 forms inaccurately.
- Measure, monitor and report your key outcomes to drive your quality assessment and performance improvement program. If your outcomes are not what you would like them to be, address them and monitor your progress. And use your positive outcomes to “tell your story” to all your stakeholders – residents, families, employees, payers, healthcare partners and the public.
ABOUT THE OUTCOMES DASHBOARD
The Decision PointTM Outcomes Dashboard provides a comprehensive, high-level view of critical outcomes metrics. Since so many others will be looking at a facility’s outcome measures as indicators of quality, it is imperative that a facility measure and monitor their outcomes.