1. IDIOT’S GUIDE TO CMS, VBP, HCAHPS, CPC, TPS OR, WHY CAN’T I JUST PRACTICE GOOD CLINICAL MEDICINE AND HAVE ALL OF YOU FIGURE OUT THIS BS?

2. $URVIVAL At Risk: significant revenue to our hospital based on measures over which we have little:  Awareness  Control over the measuring process  Control over outcomes beyond our own practice  System in place to ensure quality control CAN WE REVERSE THIS? YES!!! WE NEED TO TAKE THE BULL BY THE HORNS.

4. SIMPLE DEFINITIONS CMS = Center for Medicare/Medicaid Services VBP = Value Based Purchasing HCAHPs = Scores based on random surveys of patients recently hospitalized CPCs = Clinical Processes of Care Outcomes Domain Measure (ODM) TPS = Total Performance Score TPS = HCAHPs + CPCs + ODM (30%) (40%) (30%)

6. WHAT SHOULD YOU ASK YOURSELF? WHEN? WHY? HOW? WHERE? CAN I HELP?

7. TIME FRAMES: PERFORMANCE IS NOT PREDICTABLE IN A CHAOTIC SYSTEM

8. Measured by others Measured by us

10. HCAHPS SCORES

12. CPC ACHIEVEMENT & BENCHMARKS

14. OUTCOMES ACHIEVEMENT & BENCHMARKS

15. BAD TIMES? – BETTER TIMES? Pre-Performance Period (Judgment Days): HCAHPS/CPCs: April 2011 to March 2012 – What was going on then? All resources diverted to preparing for ccLink Disgruntled staff pissed off about not having a summer vacation Denis Mahar came back to the county without his beard? Pre-Performance Period (Judgment Days): Outcomes Measures: July 2008 to June 2011 Performance Period (Real Judgment Days): HCAHPS/CPCs: April 2012 to December 2012 Outcomes Measures – July 2011 to June 2012

16. HOW DO WE REVERSE THIS? As Medical Staff Leaders, We Need To: Understand the process Understand the measures Understand how to accurately interpret and communicate this process & measures to our staff members Take responsibility for the measures that are the outcomes of our departments Demand accountability from ourselves; our quality/administrative leaders; our colleagues and our Board