Addressing hospital value based purchasing complexity

By Harshad Patil
08:53 AM

Accelerating Reporting Timelines

In order to stay ahead, hospitals need to identify any problematic areas upfront and address them accordingly prior to the performance period. This can be done with analytic-driven, real-time reports that offer individual or overall scores. Physicians and administrators can then compare these scores with publicly available benchmarks or baseline scores to track the hospital’s performance and improvement. Tools available today provide various filtering capabilities that can accelerate the generation of these reports, allowing stakeholders to identify at-risk, inefficient, or wasteful areas and take corrective action to improve profitability.

Predicting Future Incentives and Penalties

The very nature of the HVBP program dictates that the impact of what a hospital does today, positive or negative, will be felt in subsequent years. For example, an organization with a lower than average total performance score today will see the financial impact in 2015. Calculating, analyzing and improving current metrics is of paramount importance since these tools allow an organization to identify current pain points and drive initiatives to address them now.

Using the consolidated real-time performance scores and applying them to the estimated future DRG amounts allows hospitals to predict the future dollar value incentives or penalties. This kind of analysis can go a long way in helping plan future moves and expenses.

Adopting the Right Analytics

With fast growing Medicare costs, the HVBP program is projected to save the government an estimated $50 billion over the next decade, while in comparison, Meaningful Use will save $17 billion and readmission reduction is estimated to result in savings of $8.2 billion. Hospitals are expected to be under extreme pressure to minimize the penalties arising out of such programs, by focusing on best-in-class quality and patient satisfaction metrics. Even if an organization is a top ranker and hence an incentive-earner today, it will still need to maintain its position or achieve improvement to be able to earn future incentives. This can be achieved by reviewing quality data periodically and identifying action items to improve staff, processes and material assets. Hospitals that quickly adopt the right tools and platforms for healthcare analytics will stand to gain from their ability to handle the complexity of HVBP calculations, use standardized metrics to measure current and future performance, and improve their adherence to evidence-based clinical measures.