Value based purchasing (VBP) is here . Just ask CMS (Centers for Medicare and Medicaid Services). But will you benefit? Close to 1,500 hospitals were penalized on their Medicare reimbursements last fiscal year. Conversely, approximately 1,200 plus hospitals received bonus checks on Medicare revenue. Since the current cap at 1.25% will grow to 2% in the next 3 years, the debate is on whether or not the technology community of vendors can have an impact in a similar way in which EMR did or meaningful use- but without the de-installs and failed implementations. Isn’t it safe to say that the hospitals which score the highest and lead the way in quality have the most robust and strategic data management strategies?
Surely Business Intelligence is the next wave of technology adoption as hospitals embrace the concept that data is money. It is. There is no denying that your hospital is basically only as valuable as your ability to prove value with data. Many hospitals today have revamped websites to show happy caring facilities with quiet rooms and a comfortable space with a pleasing mission statement. If only Medicare would accept such gleeful testaments to quality. But alas, it’s not enough to report on a happy experience by a patient or a positive outcome or to report on mortalities. Instead, how you improve these numbers over the base line experience period is what will drive your TPS (Total Performance Score). So, let’s say you have done a great job- the tough part is now you need to do better- against your peers-who have dashboards and data management and ways to improve beyond monthly reviews of 50 tab spreadsheets.
But let’s not be drawn to the allure of only one definition of value. Value can be perceived and delivered in many ways as can cost effectiveness and efficiency. In fact, next year cost effectiveness of Medicare beneficiary spending is the next domain of quality for the TPS. Together, efficiency, quality and cost effectiveness, are the confluence we now refer to as value. But aside from CMS’ definition, how is it achieved and perceived? Because perception is reality.
Data drives value.
Improving a hospitals positioning in terms of negotiating with commercial payers, physicians, and the community requires that data be accessible, timely and valid. Empowering employees with actionable data allows for improvement on baseline performance for VBP and also allows for capital recovery and precise analysis of the core drivers and eroding factors on case margins. This is because when accounting, finance, service lines and managers in nursing see outliers and variations in care processes, variable costs and margins, individual contributors can take ownership of variances to target in real time and help steward the course through efficiency, quality and cost effectiveness and then you arrive at value.
Aculyst offers monthly webinars on how to steward your data driven value proposition. Based on business intelligence best practices, Aculyst offers a pre-built data model which empowers end users with actionable information, which leads to better decisions and business outcomes. Please look out for your invite to the Catalyst webinar- coming this February. The theme: data is money.