Need a New Year's Resolution? Sell Your Quality and Up Your Game!
Back in 2008 CMS began posting Nursing Home Compare, and ranking nursing facilities by a "5 Star" system, based on a formula measuring survey results, staffing data, and quality measures. The goal was to assist consumers in making distinctions between the good and bad performers.
As a field we've argued about the accuracy, timeliness, gaming, etc. of the ranking but since it didn't seem to greatly effect how residents came to us, most senior care organizations have continued to operate 'business as usual'.
This year though, you have a new VIP "consumer": your local hospital(s). Maryland hospitals are entering into preferred network arrangements with their post-acute neighbors. You must educate them of your value, of your quality and how it helps their bottom line.
In the not too distant future, managed care could be another consumer. Don't believe me? UMMS bought Riverside Health in mid 2015 to serve the Medicaid population. DHMH is forming a "Duals Care Delivery Workgroup" and is designing a care delivery strategy to address quality, high costs, misaligned incentives, and promote care coordination. Sounds like managed care to me.
Sooner, not later these new consumers will be seeking senior care organizations that demonstrate quality care, and can produce credible metrics that prove quality.
Where Do You Rank?
Maryland's SNFs need to know for both (federal) 5 Star and (state) Pay-for-Performance:
- your organization's current & past ranking;
- why you are ranked where you are;
- how you compare to your competition; and
- how to improve your rank.
To give you a head start, we've already pulled the lists - here are links for the Maryland 5 Star and P4P.
For assisted living, CCRCs, home health, adult day and others, become experts in:
- creating a set of quality metrics;
- maximizing your metrics; and
- making a credible case for measures that put your organization in the best possible position.
DHMH recently posted a partial list of 'pay for performance' rankings of Maryland nursing facilities.
No One Escapes the Move to Measuring Quality
Regardless of the kind of senior care you are providing, "consumers" will increasingly want to know how your organization measures up. Value-based purchasing is the new driver, not just because CMS is going there, but insurers & managed care organizations are as well.
This is not about subjective measures: person-centered care, consumer choice, satisfaction, etc., but more quantitative: admission and re-admission rates, staffing ratios & stability, anti-psychotic med use. Future measures could gravitate toward CMS quality measures (ADLs, falls, UTIs, etc.).
Make this the year that you gather your organization's data and begin refining your pitch. Make the business case for why your organization's quality of care will get your new "consumers" where they want to go.