Tahoe Hospital Rewarded by Medicare for High Quality Patient Outcomes
Barton Memorial Hospital has received notification from the Centers for Medicare & Medicaid Services (CMS) that it will receive an additional .5 percent in Medicare reimbursement for its high performance scores in patient care. Barton Hospital was compared to other hospitals nationally for its work in quality outcomes, patient safety and patient satisfaction. The higher reimbursement will be allocated from October 2014 through September 2015.
In a separate assessment, Barton Memorial Hospital has also received notification that it will not receive a penalty from the CMS’s Hospital–Acquired Condition (HAC) Reduction Program, as erroneously speculated by Kaiser Health News (www.kaiserhealthnews.org/Stories/2014/June/23/patient-injuries-hospitals-most-likely-to-be-penalized.aspx) and other media sources. As required by the Affordable Care Act, the HAC Reduction Program penalizes the lowest-performing hospitals who score comparatively less, in the bottom 25 percent, in patient safety measures.
Starting October 1, hospitals with the lowest-performing scores will collect one percent less in Medicare reimbursement from CMS for the full year. CMS has notified Barton Hospital that the hospital’s performance between 2011 and 2013 exceeded its peers and is not eligible for any penalties.
The HAC reduction program is based on patient safety indicators and infection rates. Examples include the rates Medicare patients experience ulcers during a hospitalization, infections caused by catheters, accidental punctures or lacerations, infections after surgeries, and readmission rates. From these measures, each hospital has two comprehensive scores that are then compared to hospitals nationwide.
“We are pleased, but not surprised that Barton is a high-performer,” says Dr. Clint Purvance, Chief Medical Officer. “Our hospital’s staff and physicians consider patient safety, quality and patient satisfaction their highest priorities. The time and energy they have invested has greatly improved the outcomes on these measures for the past several years and continues to do so.”
Barton Hospital’s .5 percent increase in reimbursement comes from the CMS’s Hospital Value-Based Purchasing (HVBP) program, a separate CMS patient-centered program mandated by health care reform. The HVBP program bases scores and reimbursements on clinical processes, patient experience, quality outcomes, and efficiencies in providing care. Hospitals are compared with their peers nationwide and rewarded or penalized, depending on their scores. In this case, Barton will receive the appropriate reimbursement as well as an additional payment for its top-notch scores.
“This additional reimbursement directly benefits all of our patients,” says Dr. Purvance. “We are excited to have this momentum and look forward to the on-going process of improving our patients’ overall experience.”