track your fy2018 hvbp progress€¦ · erik zabel, phd, mph lake superior quality innovation...

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Track Your FY2018 HVBP Progress Vicki Tang Olson, RN, MS Erik Zabel, PhD, MPH Lake Superior Quality Innovation Network September 14, 2016 1 Objectives Understand the purpose for FY2018 value-based purchasing (VBP) worksheet Review the reports and data that are used to populate the baseline and performance periods on the VBP worksheet Describe how the measures or domain percentages are reallocated if there is low volume that affects eligibility of a measure or domain Look for opportunities for improvement in future years

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  • Track Your FY2018 HVBP ProgressVicki Tang Olson, RN, MSErik Zabel, PhD, MPH

    Lake Superior Quality Innovation NetworkSeptember 14, 2016

    1

    Objectives

    • Understand the purpose for FY2018 value-based purchasing (VBP) worksheet

    • Review the reports and data that are used to populate the baseline and performance periods on the VBP worksheet

    • Describe how the measures or domain percentages are reallocated if there is low volume that affects eligibility of a measure or domain

    • Look for opportunities for improvement in future years

  • 2

    FY2018 VBP

    3

    VBP Fact Sheet

    https://www.lsqin.org/wp-content/uploads/2015/11/FY2018-VBP-Fact-Sheet 11.10.pdf

  • 4

    FY2018

    CTM-3 is New

    PC-01 moved to Safety domain

    5

    FY2018

    Quality Reporting CenterOverview of the Hospital Value-Based Purchasing

    (VBP) Fiscal Year (FY) 2018 - 1 C.E.Date: February 23, 2016http://www.qualityreportingcenter.com/wp-content/uploads/2016/02/VBP_FY2018_BaselineOverview_February2016_01272016_FINAL-5081.pdf

  • 6

    FY2018 Worksheet

    7

    FY2017 VBP Worksheet

    • Proxy for FY2018 results you will receive next summer (July 2017)

    • Way for you to track your progress as you go through this year

    • Enter your hospital data in green cells

    • Baseline results are accurate and static so are only entered once

    • Performance results can be updated quarterly as you get more current data

    Clinical Care

    PatientExperience

    Safety

    Efficiency

  • 8

    Purpose of VBP Worksheet

    • Monitor progress for FY2018 VBP performance• Identify priorities for improvement• Answer questions from senior leadership as to how you

    might do when you get results next summer – understand risk and get support

    • Understand the measure and domain calculations• Understand the differences between achievement,

    improvement points and what happens if you are not eligible for a measure or domain

    9

    Accept Messages and Enable Content

  • 10

    Tabs in Excel Spreadsheet

    Three tabs in Excel spreadsheet• Baseline instructions• Performance instructions• VBP worksheet

    11

    Preparation for using the FY2018 VBP Worksheet

  • 12

    Need 3 Reports

    FY2018 Baseline report• Run report and download from QualityNet

    Inpatient Preview report – most current• Run report and download from QualityNet

    Medicare Spending per Beneficiary report – most current is calendar year 2015

    • Download from secure file transfer area in QualityNet

    13

    Access HVBP Baseline Report

  • 14

    Access HVBP Baseline Report

    15

    FY2018 Baseline Report

  • 16

    Access IQR Preview Report

    17

    Assess IQR Preview Report

  • 18

    IQR Preview Report

    1234 OAK STANYTOWN, USA 12345

    THE BEST(111) 123-6789

    xxxxxx MY HOMETOWN HOSPITAL

    19

    MSPB Report

    MY TOWN HOSPITALPROVIDER ID: XXXXXX (CCN #)

    ANY STATE

    Pushed to hospitals annually via QualityNet Secure File Exchange:

  • 20

    Clinical Care Domain

    21

    Clinical Care - Eligibility

  • 22

    Baseline Report

    Need 25 cases

    23

    Inpatient Preview Report

  • 24

    Small PPS Example

    Y changed to N since

  • 26

    Patient Experience Domain

    27

  • 28

    Pt Experience - Eligibility

    29

    Baseline Report

  • 30

    Inpatient Preview Report

    Use % Always column

    31

    Inpatient Preview Report

    Use % Always column

  • 32

    Small PPS Example

    Baseline report combines cleanliness and quietness so performance data calculates average as a proxy for the measure

    33

    Consistency Points

    HCAHPS Consistency Score The HCAHPS Consistency Score reflects points that were awarded based on a

    hospital’s lowest HCAHPS dimension score during the performance period. The higher a hospital’s lowest dimension score is above the “floor” (i.e., the worst-performing hospital’s dimension rate from the baseline period), the more consistency points the hospital will receive. A hospital can earn between 0 and 20 points towards its PCCEC/CC domain as follows:

    20 points: If all of a hospital’s dimension rates during the performance period is greater than or equal to their respective achievement thresholds.

    0 points: If any of a hospital’s dimension rates during the performance period are less than or equal to the worst-performing hospital’s dimension rate (floor) from the baseline period.

    0–19 points: If any of a hospital’s dimension rates are greater than the worst-performing hospital’s rate (floor) but less than the achievement threshold from the baseline period.

  • 34

    35

    Large PPS Example

  • 36

    Safety Domain

    37

    Safety - Eligibility

  • 38

    Baseline Report

    39

    Inpatient Preview Report

    Ignore NA – there is no information about eligibility. Need to assume if you have a result, that you had enough cases

  • 40

    Inpatient Preview Report

    Order is not the same as the baseline report so need to be careful about entry into the worksheet

    41

    Inpatient Preview Report

  • 42

    Small PPS Example

    43

    Large PPS Example

  • 44

    Efficiency and Cost Reduction Domain

    45

    Efficiency - Eligibility

  • 46

    Baseline Report

    47

    MSPB Report

  • 48

    Small PPS Example

    Proxy using 2014 data

    49

    MSPB Percentiles

    20142015

  • 50

    Overall Calculation

    51

    Total Performance Score

    26.67 x 25% + 39 x 25% + 40 x 25% + 40 x 25% =

    6.6675 + 9.75 + 10 + 10 = 36.4175

  • 52

    Reallocation

    53

    Looking back

    FY2017 HVBP Final Report(Reports available July 31, 2016)

  • 54

    Value-Based Incentive Payment Percentage by Program Fiscal Year

    Fiscal Year Percent Reduction2013 1.02014 1.252015 1.52016 1.752017 2.0

    55

    Payments

    A hospital may earn back a value-based incentive payment percentage that is less than, equal to or more than the applicable reduction for that program year.

  • 56

    Access HVBP Report

    • Available on QualityNet

    • Only Active QualityNet Users

    • Both the Hospital Reporting Feedback Inpatient Role and the File Exchange & Search Role are required

    • Sign in to QualityNet Secure Portal

    • Select “Run” under My Reports

    57

  • 58

    59

    How to Read Your Reports

    Quality Reporting Center

    Hospital VBP: FY 2017 Percentage Payment Summary Report - 1.5 C.E.

    Date: July 26, 2016http://www.qualityreportingcenter.com/wp-content/uploads/2016/07/VBP_FY2017_PPSROverview_NPC_07122016-GHI-7-17-2016.508.pdfFind

  • 60

    How to Read Your Reports

    QualityNet Find instructions for how to read your fiscal year

    hospital VBP payment summary report here:How to Read Your FY 2017 Hospital Value-Based Purchasing (VBP) Program Percentage Payment Summary Report (PPSR), PDF-1.5 MB

    61

    FY2017 Lake Superior Quality

    Innovation Network (QIN)Reports

  • 62

    Lake Superior QIN Reports

    FY 2017 VBP Comparison Report• Available late this fall• State and regional comparison of VBP domains

    and measures

    63

    Report Example – Total Performance Score

  • 64

    Looking forward

    FY2019 VBP

    65

    FY2019

    25%

    25%25%

    25%

    Person and CommunityEngagementClinical Care

    Safety

    Efficiency and Cost

  • 66

    FY2019

    • New! Hospital-Level Risk –Standardized Complication Rate(RSCR) Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA)

    • CLABSI and CAUTI will include nonICU locations and will use new standard population data

    • PSI 90 will be proposed to be removed in future rulemaking to allow for the modified PSI 90 in future years

    • HCAHPS Pain Management?

    67

    Future years

    FY2021• AMI Episode Payment• Heart Failure Episode Payment• 30 Day Mortality Pneumonia (updated cohort)• 30 Day Mortality COPD

    FY2022• 30 Day Mortality CABG

  • 68

    Questions?

    State contacts:Minnesota: Vicki Tang [email protected]: Donna Modras [email protected]: Ross [email protected]

    Follow us online @LakeSuperiorQIN

    Thank you!

    This material was prepared by the Lake Superior Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 11SOW-MI/MN/WI-D1-16-47 091216