Rapid Identification of Hospital Core Measure Patients Improves Hospital Bottom Line
Even one miss on a hospital core measure can mean the loss of a significant amount of money for an organization, says Dr. Steven Berkowitz, MD, president SMB Health Consulting and former chief medical officer of St. Davidís Healthcare System, which has among the best CMS core measures in the country.
To become successful with core measures, hospitals need to develop an organizational culture of zero misses, explained Dr. Berkowitz during the recent webinar Healthcare Performance Improvement: Exceeding Core Measure Targets for Value-Based Reimbursement.
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With the upcoming changes to Medicare reimbursement, hospitals are no longer focusing on core measures for quality, but for the financial bottom line, said Dr. Berkowitz. Therefore, it is vital to identify every core measure patient.
Most of the core measure patients come out of the emergency room (ER), said Dr. Berkowitz. This presents the opportunity to identify them as heart failure (HF), acute myocardial infarction (AMI) and pneumonia patients.
One strategy to rapidly identify core measure patients is to note every direct hospital admission to the concurrent reviewer so that the patient is on the potential core measure radar screen before they even hit the floor of the hospital.
In addition, each measure must be reviewed individually. Ownership should be assigned to different people for each measure. According to Dr. Berkowitz, everyone should know whether they are the one responsible or not. This allows for policies and procedures to be put in place that create accountability. For example, if a nurse misses a core measure, that nurse is accountable to the CEO of the hospital to explain why that measure was missed.
According to Dr. Berkowitz, it is important to check, check and recheck the core measures. When looking at each measure, such as HF, ask detailed questions like: How do we identify the patient? How do we make sure that the patients receive the packet per discharge instructions? How do we confirm these packets are matched up with the physicianís discharge?
Dr. Berkowitz also shared with webinar participants:
You'll also get to listen to the question and answer session to hear how St. Davidís Healthcare core measures success has impacted negotiations and payment rates by private health plans; the ongoing monitoring and education requirements for core measures; overcoming physician resistance to the processes put in place to improve core measure targets and the reporting of the data; achieving the culture change needed to get zero misses; and addressing the challenge of getting a multidisciplinary team to work together.
You can watch this program right in your office and enjoy significant savings ó no travel time or hassle; no hotel expenses. Itís so convenient! Invite your staff members to view this conference. We will send you a DVD or CD-ROM of the conference proceedings or a link to our web site with a username and password. You can log in and watch the program right from your computer ó any time of the day or night, whenever convenient for you and your colleagues ó and benefit from the replay of the conference, including the Q&A period.
Here's what participants said about the program:
"Dr. Berkowitz was genuine, honest, and presented an "I've been in your shoes" practical format. Key advice on implementation related to individual ownership. Helped us feel that we could also be successful," said Terri Jones, Mary Greeley Medical Center.
To register for the on-demand replay of Healthcare Performance Improvement: Exceeding Core Measure Targets for Value-Based Reimbursement or order the training DVD or CD-ROM, please visit:
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