MedPAC on Quality Measures, Readmissions, and more ...

MedPAC Suggests Revamping Quality Measure Programs

The Medicare Payment Advisory Commission (MedPAC) submitted its mandated annual report to Congress last week, and once again called for a total revamping of Medicare’s hospital quality programs.
In June 2018, MedPAC called for replacing four existing quality programs with a single new program to be known as the Hospital Value Incentive Program (HVIP).
The existing quality programs – the Hospital Inpatient Quality Reporting Program (IQRP), Hospital Readmissions Reduction Program (HRRP), Hospital-Acquired Condition Reduction Program (HACRP), and Hospital Value-Based Purchasing (VBP) Program – adjust hospital payments based on how hospitals perform in meeting the programs’ measures.
MedPAC says the current programs are “complex” and often “duplicative” and could be streamlined. The proposed HVIP includes five CMS-administered measure domains: mortality, readmissions, Medicare spending per beneficiary (MSPB), patient experience, and hospital-acquired conditions.
“Payments under the HVIP would be financed by a payment withhold from each hospital’s base operating payments (e.g., 5 percent) and increased by the difference between the Commission’s update recommendation for acute care hospitals and the amount specified in current law,” MedPAC wrote.
MHA is still reviewing the details of MedPAC’s 500-plus page recommendations. However, in general, while hospitals have advocated for simplified quality reporting, MedPAC’s suggestion of using all-cause, all condition readmission and mortality measures raises concern. Hospitals have argued that condition-specific measures are more valuable because they allow a hospital to burrow down and target problem areas. Also, nationally, the validity and value of financial penalties for readmissions is increasingly being called into question.
Other MedPAC suggestions in its 2019 report call for reducing the FY 2019 Medicare base payment rate for inpatient rehabilitation facilities by 5%, increasing the FY2019 base rate for long-term hospitals by 2%, and reducing the calendar year 2019 Medicare base payment rate for home health agencies by 5%.

Hospital-Specific Readmissions Reports

The state’s Center for Health Information & Analysis (CHIA) last Tuesday released hospital-specific readmission profiles for each acute care hospital in the state. Anyone viewing the reports can find readmissions by age, payer type, discharge condition, and readmissions to other hospitals, among many other variables.
Also last Tuesday, CHIA partnered with MHA and Collaborative Healthcare Strategies to hold a webinar on the new reports. MHA’s V.P. of Clinical Affairs Patricia Noga, R.N., PhD, said the webinar was yet another step in the ongoing, collaborative process the healthcare system – hospitals, physicians, post-acute providers, nursing homes, home healthcare agencies, and more – have undertaken to address readmissions.
Noga said one takeaway that resonated was the importance of providers looking at their population of multi-visit patients and delving into the reasons why they continue to be readmitted. Multi-visit patients account for four or more inpatient admissions in the past 12 months and usually account for the majority of the 30-day readmissions to a hospital. You can view the CHIA reports here.

UMass Memorial Health Care Wins Prestigious Vista Award

Congratulations to UMass Memorial Health Care which last week was recognized by the American Hospital Association’s American Society for Health Care Engineering (ASHE) for the system’s renovation of its Memorial and University Hospital campuses. ASHE awards three national Vista awards each year for best new construction, renovation, and infrastructure.
UMass’s “MC2020” project increased the number of private patient beds, transitioned nurses’ stations into collaborative Team Stations, increased learning and discovery space at the Memorial Campus, and, in general, created “a more standardized person-centered experience.”

Mark Your Calendars for Healthcare Decisions Day

April 16 is National Healthcare Decisions Day, on which the healthcare community stresses the importance of advance care planning – that is, making sure you can receive the medical care you want even if you are not in a position to articulate it yourself.
Throughout April, providers will be encouraging patients and families to focus on the process that you want your loved ones and caregivers to follow if you become seriously ill. One of the easiest ways to start this process is to designate someone as your healthcare agent and make sure your agent knows your wishes by filling out a simple healthcare proxy.
Lots of information exists to start you down the advance care planning path. Visit PatientCareLink and then click on “Healthcare Planning Throughout Your Life” under the For Patients & Families tab, or “Serious Illness Care” under Improving Patient Care.

Annual Design, Operations and Construction Conference

Friday, May 17; 7:30 a.m. - 1:30 p.m.
MHA Conference Center, Burlington, Mass.

Join us at MHA's Annual Design, Operations & Construction Conference where we'll provide the latest information on critical topics for hospitals. We’ll look specifically at today's security and emergency management issues, professional development tools within the sector, and current projects of interest. We'll also take a deeper dive into what hospital facilities are doing on construction for behavioral healthcare, and for mitigating maintenance issues. This program always provides great education, information, and networking. And please note: This conference is free of charge for facilities professionals employed by MHA member hospitals. We hope to see you there! Click here for panelist info and more information.

John LoDico, Editor