The

Just for level setting, value=quality/cost. Unfortunately, physician payment structure still rewards volume over quality, hence the continued rising cost, and lack of improvement in the value proposition.

Although most physicians believe that the current structure does not adequately financially reward providers for quality, only 1/3 support public reporting.

A pertinent quotation: “If the MDs don’t develop quality measures, the MBAs will.”

The PQRS program is currently elective, with nominal payment incentives, but will become a negative incentive for non-participating providers in 2015. The next step will be the physician feedback program (known as PRUR), which will evolve into the VBP program by physician. Similar to the hospital VBP program, it will be budget neutral, and will be piloted in selected physician groups in 4 states, then rolled out to all physicians in 2017.

Key takeaways for Hospitalists:

• CMMS is moving from public reporting → pay for VALUE performance, for all physicians, through the PQRS → PRUR → VBP programs.
• All physicians need to familiarize themselves with the data and the attribution models.
• All physicians need to gain QI skills to improve their performance metrics.

Just for level setting, value=quality/cost. Unfortunately, physician payment structure still rewards volume over quality, hence the continued rising cost, and lack of improvement in the value proposition.

Although most physicians believe that the current structure does not adequately financially reward providers for quality, only 1/3 support public reporting.

A pertinent quotation: “If the MDs don’t develop quality measures, the MBAs will.”

The PQRS program is currently elective, with nominal payment incentives, but will become a negative incentive for non-participating providers in 2015. The next step will be the physician feedback program (known as PRUR), which will evolve into the VBP program by physician. Similar to the hospital VBP program, it will be budget neutral, and will be piloted in selected physician groups in 4 states, then rolled out to all physicians in 2017.

Key takeaways for Hospitalists:

• CMMS is moving from public reporting → pay for VALUE performance, for all physicians, through the PQRS → PRUR → VBP programs.
• All physicians need to familiarize themselves with the data and the attribution models.
• All physicians need to gain QI skills to improve their performance metrics.

Just for level setting, value=quality/cost. Unfortunately, physician payment structure still rewards volume over quality, hence the continued rising cost, and lack of improvement in the value proposition.

Although most physicians believe that the current structure does not adequately financially reward providers for quality, only 1/3 support public reporting.

A pertinent quotation: “If the MDs don’t develop quality measures, the MBAs will.”

The PQRS program is currently elective, with nominal payment incentives, but will become a negative incentive for non-participating providers in 2015. The next step will be the physician feedback program (known as PRUR), which will evolve into the VBP program by physician. Similar to the hospital VBP program, it will be budget neutral, and will be piloted in selected physician groups in 4 states, then rolled out to all physicians in 2017.

Key takeaways for Hospitalists:

• CMMS is moving from public reporting → pay for VALUE performance, for all physicians, through the PQRS → PRUR → VBP programs.
• All physicians need to familiarize themselves with the data and the attribution models.
• All physicians need to gain QI skills to improve their performance metrics.

We now have, in effect, a parliamentary system, with no overlap between democrats and republicans, which is it is rooted in a system that does accept a parliamentary system, said Ornstein.  This is playing out as “utterly dysfunctional.” This “tribalism” has extended out many states, and the Supreme Court, with innumerable controversial 5-4 decisions.

Bottom Line

• The chasm between republicans and democrats is wider than ever

• This is spilling out to states and the Supreme Court

• Fasten your seatbelts as the coming months will be tumultuous

• But business is booming for political analysts!

We now have, in effect, a parliamentary system, with no overlap between democrats and republicans, which is it is rooted in a system that does accept a parliamentary system, said Ornstein.  This is playing out as “utterly dysfunctional.” This “tribalism” has extended out many states, and the Supreme Court, with innumerable controversial 5-4 decisions.

Bottom Line

• The chasm between republicans and democrats is wider than ever

• This is spilling out to states and the Supreme Court

• Fasten your seatbelts as the coming months will be tumultuous

• But business is booming for political analysts!

We now have, in effect, a parliamentary system, with no overlap between democrats and republicans, which is it is rooted in a system that does accept a parliamentary system, said Ornstein.  This is playing out as “utterly dysfunctional.” This “tribalism” has extended out many states, and the Supreme Court, with innumerable controversial 5-4 decisions.

Bottom Line

• The chasm between republicans and democrats is wider than ever

• This is spilling out to states and the Supreme Court

• Fasten your seatbelts as the coming months will be tumultuous

• But business is booming for political analysts!

CMS has evolved from a passive payor to an active facilitator and catalyst for quality improvement, with a “relentless focus” on what is the right thing to do for patients, Pat Conway told more than 2,000 hospitalists at HM12 in San Diego this morning.

There are a myriad of efficiencies and tactics being implemented at CMS to enhance the ability to roll out best practices across the board, in rapid cycle sequence. The future of safety is moving from individual safety breaches to an “all-cause harm” metric that tracks across setting.

A big focus in the next 2 years will be reduction of readmission (with financial penalties) and a reduction of hospital-acquired conditions (through the Partnership for Patients).

CMS is moving toward:

• Patient-centered outcomes;
• Reducing burdensome measurements; and
• Anticipating and mitigating unintended consequences;

Send your comments and feedback to: patrick.conway@cms.hhs.gov

CMS has evolved from a passive payor to an active facilitator and catalyst for quality improvement, with a “relentless focus” on what is the right thing to do for patients, Pat Conway told more than 2,000 hospitalists at HM12 in San Diego this morning.

There are a myriad of efficiencies and tactics being implemented at CMS to enhance the ability to roll out best practices across the board, in rapid cycle sequence. The future of safety is moving from individual safety breaches to an “all-cause harm” metric that tracks across setting.

A big focus in the next 2 years will be reduction of readmission (with financial penalties) and a reduction of hospital-acquired conditions (through the Partnership for Patients).

CMS is moving toward:

• Patient-centered outcomes;
• Reducing burdensome measurements; and
• Anticipating and mitigating unintended consequences;

Send your comments and feedback to: patrick.conway@cms.hhs.gov

CMS has evolved from a passive payor to an active facilitator and catalyst for quality improvement, with a “relentless focus” on what is the right thing to do for patients, Pat Conway told more than 2,000 hospitalists at HM12 in San Diego this morning.

There are a myriad of efficiencies and tactics being implemented at CMS to enhance the ability to roll out best practices across the board, in rapid cycle sequence. The future of safety is moving from individual safety breaches to an “all-cause harm” metric that tracks across setting.

A big focus in the next 2 years will be reduction of readmission (with financial penalties) and a reduction of hospital-acquired conditions (through the Partnership for Patients).

CMS is moving toward:

• Patient-centered outcomes;
• Reducing burdensome measurements; and
• Anticipating and mitigating unintended consequences;

Send your comments and feedback to: patrick.conway@cms.hhs.gov

Quality and Patient Safety have become the cornerstone of the ways that hospitalists can improve inpatient care delivery. At this year’s annual meeting, the focus on quality and safety is represented through a series of dynamic workshops that will allow practicing hospitalists to learn practical skills in quality improvement, to contribute to the development of standards on the discharge process, and to understand emerging models of care delivery that may impact inpatient mortality. Below is a brief summary of the workshops and their objectives:

1. Hospital Mortality Reduction— the Role of Rapid Response Teams: Faculty from the Institute for Healthcare Improvement and leading patient safety programs will present an overview of the concept of rapid response teams, data their effectiveness, and examples of their implementation. Hospitalists are often advocates for patient safety and quality in their institution and will be critical in the development of initiatives to reduce inpatient mortality.
2. The Role of Information Technology in Quality Improvement and Safety: A dynamic team of physician leaders in quality and safety will review the literature in the use of information technology to improve quality and safety. Examples of IT approaches to improve inpatient care will be described and discussed. In addition, potential barriers in the use of IT-based approaches to quality and safety will be outlined. Hospitalists will learn about how to integrate existing IT support into quality initiatives and when IT may not be essential to process change.
3. A Primer on Root Cause Analysis: Hospitalists may be asked to be part of interdisciplinary teams that review sentinel events through root cause analysis using tools such as Failure Mode Effects Analysis (FMEA). This process can often uncover system-issues that contribute to quality and safety issues. However, it is critical for hospitalists to understand the root cause analysis process, its limitations, and how to maximize the potential of FMEA to identify underlying issues critical to improving patient care and safety.
4. Consensus Group/Workshop to Develop the Ideal Discharge Process: Discharging patients from the hospital is a necessary task in every hospital admission, but one that has had very little study or standardization. Hospitalists are critical agents of change in reframing the discharge process and in developing and implementing tools to make that process as safe and efficient as possible. A panel of hospitalists and experts on patient safety especially at care transition points will moderate an open forum to establish guidelines for the ideal hospital discharge. Input from participants will be used to shape guidelines and tools for discharge.
5. Quality Improvement for the Clinical Hospitalist: This workshop is targeted at bringing quality improvement from the ivory tower to the practicing hospitalist. Participants will be exposed to basic quality improvement tools and strategies that can be applied in myriad settings to improve care. Examples of successful projects will be presented for discussion.

We will be evaluating participation in the quality and patients safety track at the meeting to help determine the need for more in-depth sessions such as a pre-course on quality assessment and improvement methodology. We are excited to offer such a diverse series of workshops and look forward to your active participation!

Quality and Patient Safety have become the cornerstone of the ways that hospitalists can improve inpatient care delivery. At this year’s annual meeting, the focus on quality and safety is represented through a series of dynamic workshops that will allow practicing hospitalists to learn practical skills in quality improvement, to contribute to the development of standards on the discharge process, and to understand emerging models of care delivery that may impact inpatient mortality. Below is a brief summary of the workshops and their objectives:

1. Hospital Mortality Reduction— the Role of Rapid Response Teams: Faculty from the Institute for Healthcare Improvement and leading patient safety programs will present an overview of the concept of rapid response teams, data their effectiveness, and examples of their implementation. Hospitalists are often advocates for patient safety and quality in their institution and will be critical in the development of initiatives to reduce inpatient mortality.
2. The Role of Information Technology in Quality Improvement and Safety: A dynamic team of physician leaders in quality and safety will review the literature in the use of information technology to improve quality and safety. Examples of IT approaches to improve inpatient care will be described and discussed. In addition, potential barriers in the use of IT-based approaches to quality and safety will be outlined. Hospitalists will learn about how to integrate existing IT support into quality initiatives and when IT may not be essential to process change.
3. A Primer on Root Cause Analysis: Hospitalists may be asked to be part of interdisciplinary teams that review sentinel events through root cause analysis using tools such as Failure Mode Effects Analysis (FMEA). This process can often uncover system-issues that contribute to quality and safety issues. However, it is critical for hospitalists to understand the root cause analysis process, its limitations, and how to maximize the potential of FMEA to identify underlying issues critical to improving patient care and safety.
4. Consensus Group/Workshop to Develop the Ideal Discharge Process: Discharging patients from the hospital is a necessary task in every hospital admission, but one that has had very little study or standardization. Hospitalists are critical agents of change in reframing the discharge process and in developing and implementing tools to make that process as safe and efficient as possible. A panel of hospitalists and experts on patient safety especially at care transition points will moderate an open forum to establish guidelines for the ideal hospital discharge. Input from participants will be used to shape guidelines and tools for discharge.
5. Quality Improvement for the Clinical Hospitalist: This workshop is targeted at bringing quality improvement from the ivory tower to the practicing hospitalist. Participants will be exposed to basic quality improvement tools and strategies that can be applied in myriad settings to improve care. Examples of successful projects will be presented for discussion.

We will be evaluating participation in the quality and patients safety track at the meeting to help determine the need for more in-depth sessions such as a pre-course on quality assessment and improvement methodology. We are excited to offer such a diverse series of workshops and look forward to your active participation!

Quality and Patient Safety have become the cornerstone of the ways that hospitalists can improve inpatient care delivery. At this year’s annual meeting, the focus on quality and safety is represented through a series of dynamic workshops that will allow practicing hospitalists to learn practical skills in quality improvement, to contribute to the development of standards on the discharge process, and to understand emerging models of care delivery that may impact inpatient mortality. Below is a brief summary of the workshops and their objectives:

1. Hospital Mortality Reduction— the Role of Rapid Response Teams: Faculty from the Institute for Healthcare Improvement and leading patient safety programs will present an overview of the concept of rapid response teams, data their effectiveness, and examples of their implementation. Hospitalists are often advocates for patient safety and quality in their institution and will be critical in the development of initiatives to reduce inpatient mortality.
2. The Role of Information Technology in Quality Improvement and Safety: A dynamic team of physician leaders in quality and safety will review the literature in the use of information technology to improve quality and safety. Examples of IT approaches to improve inpatient care will be described and discussed. In addition, potential barriers in the use of IT-based approaches to quality and safety will be outlined. Hospitalists will learn about how to integrate existing IT support into quality initiatives and when IT may not be essential to process change.
3. A Primer on Root Cause Analysis: Hospitalists may be asked to be part of interdisciplinary teams that review sentinel events through root cause analysis using tools such as Failure Mode Effects Analysis (FMEA). This process can often uncover system-issues that contribute to quality and safety issues. However, it is critical for hospitalists to understand the root cause analysis process, its limitations, and how to maximize the potential of FMEA to identify underlying issues critical to improving patient care and safety.
4. Consensus Group/Workshop to Develop the Ideal Discharge Process: Discharging patients from the hospital is a necessary task in every hospital admission, but one that has had very little study or standardization. Hospitalists are critical agents of change in reframing the discharge process and in developing and implementing tools to make that process as safe and efficient as possible. A panel of hospitalists and experts on patient safety especially at care transition points will moderate an open forum to establish guidelines for the ideal hospital discharge. Input from participants will be used to shape guidelines and tools for discharge.
5. Quality Improvement for the Clinical Hospitalist: This workshop is targeted at bringing quality improvement from the ivory tower to the practicing hospitalist. Participants will be exposed to basic quality improvement tools and strategies that can be applied in myriad settings to improve care. Examples of successful projects will be presented for discussion.

We will be evaluating participation in the quality and patients safety track at the meeting to help determine the need for more in-depth sessions such as a pre-course on quality assessment and improvement methodology. We are excited to offer such a diverse series of workshops and look forward to your active participation!