Leadership on Value-based Purchasing
The Society recognizes the challenges that Value–based Purchasing introduces to the marketplace. New measures – Quality, Cost and Patient Satisfaction – will soon become standard measures in an industry which is already crowded with changing guidelines, standards, new measures and evolving technologies.
It can be dizzying, but the Society has two solutions.
Value-based Purchasing Summits
First, our Value-based Purchasing Summits, coming Fall 2013. Click here to sign up for updates when further Summit details become available.
This Summit series will bring together industry leaders to discuss, outline and prepare the hospital community -- especially CEOs, doctors and nurses in Observation Medicine in the basics of "how to " connect the dots on VBP in their facilities.
It will detail the evolution of VBP, give real world examples of how hospitals are thinking differently about the three core values -- quality, cost and patient satisfaction -- and how that equates to success.
Tools and Processes to Help Comply with VBP
Secondly, we are building the aspects of the core components into our service lines for Heart Failure v2.0, Chest Pain and A-Fib.
HF v2.0 is an operational model for facilities to plan and organize the delivery of care in a systematic manner that supports the adherence to evidence-based guidelines and quality initiatives. Our new HF accreditation incorporates the principles of Value-based Purchasing (VBP) to help facilities with achieving optimal financial, quality and patient satisfaction outcomes.
SCPC's approach to HF is radically different from others that set specifications and measure compliance. SCPC's Review Specialists take a collaborative approach by providing feedback, education and resources to assist the facility in addressing gaps and improving processes.
HF v2.0 is for hospitals interested in:
A special consultant on various projects at SCPC, he is a health care leader with 15 years experience managing teams of 4-50 and budgets of $250K - $14M for private sector firms and government agencies.
In his last four positions, he added $100M+ in value, reported directly to C-level officers and was recognized as an innovative problem-solver and team-builder with excellent research, written, and verbal communication skills.
He is currently President of Aggressive Analytics which specializes in improving health system operations through internal performance improvement and external strategy development and execution. Clients span the country and include health care providers, integrated delivery systems, professional societies, health plans, law firms, information technology companies, and government agencies.
Prior to that, he was Senior Quality Advisor at the Center for Medicare & Medicaid Services (CME) where he served as an agency lead for Value-based Purchasing (VBP) / Payment for Performance (P4P) and was selected by the Secretary of Health & Human Services to co-chair the Federal Advisory Committee charged with helping CMS develop a new payment system. He was also selected by the Administrator to serve as senior staff to CMS' Quality Council and Chairman of the Priorities Workgroup responsible for leading CMS' quality initiatives.
He was also a Member, National Committee on Vital Health and Health Statistics for the Dept. of Health and Human Services.
Dr. Berkowitz has been on the Board at the Society for three years and does approximately 50 VBP speaking engagements annually. He is also currently the Chair of the SCPC Congress Committee and was recently named Managing Director at Navigant Consulting.
He was founder and President, SMB Health Consulting, but most recently has evolved into a national figure for Value-based Purchasing (VBP).
A Board Member at Texas Institute of Healthcare Quality and Efficiency. He's also on the Board of Directors at Texas Association of Healthcare Quality.
A former Chief Medical Officer Central and West Texas Divisions HCA at St. David's Health, Berkowitz was also a National Practice Leader at Hay Group, and Managing Director, Medical Affairs at Harris Methodist. He has been on the Board of the Texas Hospital Association.
The concept of value-based health care purchasing, according to CMS, is that buyers should hold providers of health care accountable for both cost and quality of care. Value-based purchasing brings together information on the quality of health care, including patient outcomes and health status, with data on the dollar outlays going towards health. It focuses on managing the use of the health care system to reduce inappropriate care and to identify and reward the best-performing providers. This strategy can be contrasted with more limited efforts to negotiate price discounts, which reduce costs but do little to ensure that quality of care is improved.
According to the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality, the definitions of Value-Based Purchasing are as follows:
The Theory of Value-based Purchasing (VBP)
The concept of value-based health care purchasing is that buyers should hold providers of health care accountable for both cost and quality of care. Value-based purchasing brings together information on the quality of health care, including patient outcomes and health status, with data on the dollar outlays going towards health. It focuses on managing the use of the health care system to reduce inappropriate care and to identify and reward the best-performing providers. This strategy can be contrasted with more limited efforts to negotiate price discounts, which reduce costs but do little to ensure that quality of care is improved.
The key elements of value-based purchasing include:
In a system based on value-based purchasing, employers and other purchasers gather and analyze information on the costs and quality of various competing providers and health plans. They contract selectively with plans or provider organizations based on demonstrated performance, or at least proposed approaches for improving performance. Ideally, quality information becomes a factor in the setting of plan prices, and employee contributions vary with each plan's "score," which reflects a combination of quality and cost indicators. In this manner, the best performing plans and providers are rewarded with greater volume of enrollees or patients.
The Reality of Value-based Purchasing
Our mapping of the terrain of value-based purchasing leads to the following conclusions:
According to CMS, that means:
Also according to CMS, the Patient Experience of Care (or Patient Satisfaction), is measured by the following criteria:
A random sample of patients discharged from hospitals across the country are surveyed and asked questions regarding their feelings and perceptions about their hospital stay. This measure combines hospital performance on questions that asked patients their levels of satisfaction with some of the following elements of their stay:
Sign up for updates when further Summit details become available
Click here to Signup for updates.
Brady Augustine, who helped write many of the CMS guidelines when he was there, is now President and CEO of Aggressive Analytics, Inc., and a consultant, who has helped the Society with VBP, especially how it is part of our new Heart Failure tool, v2.0
Formerly known as the Society of Chest Pain Centers, the Society of Cardiovascular Patient Care will focus on facility accreditation and certification for Chest Pain Centers, Acute Coronary Syndromes (ACS), Heart Failure (HF), and Atrial Fibrillation (A-fib). In addition, SCPC will provide certification for Chest Pain Center Coordinators, nurses, administrators and Chief Financial Officers looking to be compliant with CMS guidelines for Quality, Cost and Customer Satisfaction.