At the beginning of 2015, Health and Human Services (HHS) set a clear goal and timeline for shifting Medicare reimbursement from the traditional fee-for-service model to a value-based model. By the end of 2016, 30% of Medicare payments will move to alternative payment models like ACOs and bundled payments, and 85% of traditional payments will be tied to quality of care measures.
Why Should PAC Providers Care?
Until recently, patients, family members, and referral sources have had limited insight into the quality of Home Health Agencies and Skilled Nursing Facilities. Moving forward, increased measurement and reporting of quality data by CMS will make it easier to compare these organizations, putting pressure on post-acute providers to out-perform their peers. Additionally, if post-acute providers do not adapt alongside payment reform, they forgo being included in the preferred provider networks that are laser-focused on high-quality, coordinated care.
How to Achieve this Goal
To earn, and keep, their seat at the table of preferred care providers, post-acute providers must demonstrate that they are actively investing in the ongoing improvement of quality measures such as:
- Reduced readmission rates
- Improved satisfaction measures (CAHPS, and Star Ratings)
- Contribution to lower episodic costs (E.g. shorten LoS)
In order to meet the standards outlined above, post-acute providers should focus on enhancing communication with their patients or residents, increasing coordination of care teams, and improving issue resolution. CipherHealth helps organizations drive and measure such improvements with automated follow-up calls, real-time data collection and alerting, and more. CipherHealth’s comprehensive suite helps post-acute providers improve clinical outcomes and increase quality rankings.