You’ve Asked Your Patients, Now What? Jeanna Founds, CPHQ Patient Experience Advisor Press Ganey Associates October 6, 2014

Today’s Agenda Review of the CAHPS Survey Layout CAHPS Projected Expansion Utilizing Data for Improving the Patient Experience Turning Data into Action The Key Components for Success

CAHPS Survey Format Evaluative Questions About You Questions Global Rating Questions Screening Questions

Be Prepared…Start Now Reimbursement from CMS will be tied to performance Public scores will be viewed by competitors, payers, and prospective patients Consumers will use CAHPS data to choose their provider CAHPS data will be used to drive future reimbursement changes Don’t wait for the publicly reported scores to know what you are doing right or wrong © 2014 Press Ganey Associates, Inc.

CMS-sponsored Quality Performance Programs 2013 2013 2013 2013 2014 2015 2016 2017 Inpatient Quality Reporting Requirement (IQR, formerly RHQDAPU) 2% of APU Outpatient Quality Reporting Requirement (OQR, formerly HOPQDRP) 2% of APU Value-based Purchasing (VBP) 1-2% Readmission Reduction Program 1-3% Hospital Acquired Conditions (Nonpayment) HAC Reduction Program 1% Meaningful Use of EHR Meaningful Use 1% Medicare Shared Savings: ACO (MSSP) 2-3+% Phys. Quality Reporting System PQRS PQRS 1.5-2% Voluntary Incentive Penalty

Value Modifier Implementation Plan 2015 Payment Medical Groups > = 100 eligible professionals – P4P voluntary Pioneer ACOs, MSSP ACOs, and CPC Participants Excluded 2016 Payment Medical Groups > = 100 professionals – P4P mandatory Medical Groups 10 to 99 eligible professionals – Only upside risk 2017 All physicians – required by law CMS can expand to additional eligible professionals

Medical Practice Products Compared KEY: = Optional module = Required module Key Domains & Time Frame Current CGCAHPS Visit Survey 2.0 CGCAHPS Visit Survey Press Ganey ACO/PQRS Visit Survey Official CMS ACO/PQRS Survey Look Back Time Period Visit Specific or 12 month look back Visit Specific or 3 month look back All questions are 6 month look back Access to Care Physician Communication Office Staff Global Rating Single Item: Likelihood to Recommend Single Item: Test Results New to ACO/PQRS Patient Visit Survey Between Visit Communication Shared Decision Making Education about Medication Care Coordination (Medical Records Question and Test Result Question) Access to Specialists Health Promotion & Education and Stewardship of Patient Resources About You © 2010 Press Ganey Associates, Inc.

The “new” normal

Transparency from Patients

http://www.pressganey.com/goto/transparency

Physician Compare

Measuring What Matters to Improve Health Care Avoidable Suffering Caused by defects in the approach to deliver care OUR GOAL: Prevent this suffering for patients by optimizing care delivery. Inherent Suffering Experienced even if care is delivered perfectly OUR GOAL: Alleviate this suffering by responding to Inherent Patient Needs.

The Shift from Volume to Value Value & Quality Volume & Costs Lower costs Higher quality Reduced utilization Better care coordination Patient engagement

Utilizing Your Facility Data

Press Ganey Real Time Data Now we can see real time data and track progress, but how do we turn this into action?

Suffering in YOUR Patient’s Words Speak up' was posted, however, I feel nurses/PSA's should review with pt. I expected staff to check on me with greater frequency. High census on unit - staffing level low. We had to wait nearly 1.5 hours to have a volunteer available to wheel me out - we were told 15 minutes. They forgot I was there. I had a good experience w/all the nurses except one and to this moment of discharge still feel she (nurse *) was not fully professional and was judgmental in meeting w/me I had difficulty with pain management & muscle spasms. This interfered with rest/recovery. I don't know how else I could have communicated my needs for improved pain management. I felt this need was not met. Just had to wait 6 hours to be admitted to a room. Bed wasn't that comfortable while waiting. Seemed like info given was inconsistent. Every one told us something different. My nurse was over worked. She had 6 total pt. to her self. I was the only one could walk, the other 5 where total care. That's why she could not help me as much.

BUT – There’s Good Stuff Too Asked me where I want my IV super awesome that I got to pick so that I was comfortable. The student or resident dr. who was assigned to me took plenty of time and came in to check on me and explain, what they found out. He was great. He kept me informed about what was coming next. The nurses were very helpful in explaining the meds, procedure and all the care. The releasing dr. was so uplifting, encouraging and kind, it was like leaving your caring family behind. I feel like I had the best care ever from the doctors and nurses. Thank you so much for giving me another life. Each nurse kept me informed, was very courteous towards me, and made me feel welcomed.

Identifying the Cause of Underperformance Experiences & Feelings List of Possible Causes Score/ Rank

Making Data Actionable

Organizational Culture that Supports Improvement Building a Foundation Vision Leadership Engagement Employee Partnership Transparency and Trust Accountability Organizational Culture that Supports Improvement

Keep Patient at the Center Efficient Care Appropriate Care Patient Safe Care Genuine Care

Thank you for your time!