Report calls for national VBP strategy, measures development process   03/05/2014
The Department of Health and Human Services should develop a national value-based purchasing strategy for Medicare analogous to its National Quality Strategy, according to a new report prepared by RAND Corp. for the department. “The strategy should outline what the federal government’s goals are for VBP and thus what constitutes success, the priority areas for measurement, a timeline for increased focus on outcomes and other high-priority measurement areas, and a coordinated research agenda across [the Centers for Medicare & Medicaid Services’] VBP initiatives,” the report states. “The strategy will also need to consider the interplay between various CMS VBP initiatives in working to advance federal goals for VBP and how those initiatives could better align incentives to providers.” The authors also encourage HHS to work with measure-development experts to chart a new strategy and process for developing performance measures that “move beyond primarily assessing processes of care to also focus on evaluating patient outcomes and the appropriate use of services,” among other actions. A companion report summarizes the current state of knowledge on the effectiveness of value-based purchasing in public and private sector health care programs.
AHA survey: Hospitals appealing half of RAC claim denials   03/05/2014
Hospitals continue to proactively appeal Recovery Audit Contractor claim denials, according to the latest results from the AHA's quarterly RACTrac survey. Hospitals participating in the survey report appealing 49% of all RAC denials, and almost half had an appeal overturned in their favor through use of the discussion period before a formal appeal. Lack of medical necessity was the top reason Medicare RACs cited to deny claims; however, nearly two-thirds of those denials were found to be for care that could have been provided on an outpatient basis rather than medically unnecessary. Hospital representatives are invited to attend a free March 27 webinar to review recent RAC policy developments and results from the survey, which helps hospitals monitor the impact of RACs and advocate for needed changes to the program. For more information, visit www.aha.org/rac.
Guide offers strategies for engaging patients and families in their care   03/05/2014
A new guide from the Agency for Healthcare Research and Quality offers evidence-based strategies to help hospitals partner with patients and families to improve their care. According to AHRQ, the guide shows how hospitals can work with patients and families as advisors; improve communication among patients, family members, clinicians and hospital staff from the point of admission; support the safe handoff of care between nurses by involving the patient and family in the change of shift report; and reduce preventable readmissions by engaging patients and family members in the transition from hospital to home.
Groups launch web tool for public health, primary care collaboration   03/05/2014
The de Beaumont Foundation, Duke Community and Family Medicine, and Centers for Disease Control and Prevention today launched Practical Playbook, a web-based resource to support primary care and public health partnerships to improve population health and reduce health care costs. The site guides users through the stages of integrated population health improvement, providing resources such as case studies and lessons learned from other partnerships.