IDIOT’S GUIDE TO

CMS,

VBP, HCAHPS, C

PC, TP

S

O R , WH Y C A N ’ T I J U S T P R A C T I C E G O O D C L I N I C A L M

E D I C I N E

A N D H A V E A L L O F Y O U F I G U R E O U T T H I S B S ?

$URVIVALAt Risk: significant revenue to our hospital based on measures over which

we have little: Awareness Control over the measuring process Control over outcomes beyond our own practice System in place to ensure quality control

CAN WE REVERSE THIS? YES!!! WE NEED TO TAKE THE BULL BY THE HORNS.

SIMPLE DEFINITIONSCMS = Center for Medicare/Medicaid ServicesVBP = Value Based PurchasingHCAHPs = Scores based on random surveys of patients recently

hospitalizedCPCs = Clinical Processes of CareOutcomes Domain Measure (ODM)TPS = Total Performance Score

TPS = HCAHPs + CPCs + ODM (30%) (40%) (30%)

WHAT SHOULD

YOU ASK

YOURSELF?

W H E N ? WH Y ? H

O W ? WH E R E ? C

A N I H E L P ?

TIME FRAMES: PERFORMANCE IS NOT PREDICTABLE IN A CHAOTIC SYSTEM

Measured by

others

Measured by us

Measured by us

HCAHPS SCORES

CPC ACHIEVEMENT & BENCHMARKS

OUTCOMES ACHIEVEMENT & BENCHMARKS

BAD TIMES? – BETTER TIMES?Pre-Performance Period (Judgment Days):HCAHPS/CPCs: April 2011 to March 2012 – What was going on then?

All resources diverted to preparing for ccLinkDisgruntled staff pissed off about not having a

summer vacationDenis Mahar came back to the county without his

beard?Pre-Performance Period (Judgment Days):Outcomes Measures: July 2008 to June 2011

Performance Period (Real Judgment Days):HCAHPS/CPCs: April 2012 to December 2012Outcomes Measures – July 2011 to June 2012

HOW DO WE REVERSE THIS?As Medical Staff Leaders, We Need To:Understand the processUnderstand the measuresUnderstand how to accurately interpret and communicate this

process & measures to our staff membersTake responsibility for the measures that are the outcomes of

our departmentsDemand accountability from ourselves; our

quality/administrative leaders; our colleagues and our Board