DOCSLIB.ORG

Creating a Successful Post-Acute Care Strategy to Reduce Unnecessary Utilization by Barry P

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Creating a Successful Post-Acute Care Strategy to Reduce Unnecessary Utilization by Barry P Creating a Successful Post-Acute Care Strategy to Reduce Unnecessary Utilization By Barry P. Ronan, FACHE, Western Maryland Health System n 2010, as Western Maryland secondarily. If an SNF Health System (WMHS) resident experienced a embarked on a value-based medical difficulty, staff care delivery journey, the would make a phone call Iboard of directors recognized to the medical director, that such transformational who would routinely send change necessitated a review the patient to the WMHS of our mission and vision ED for evaluation. statements, as well as our The time of day or core values. It was obvious severity of illness Key Board Takeaways that as our care delivery was irrelevant; the Hospital and health system boards should be model changed, our culture Barry P. Ronan, FACHE normal procedure aware of the deployment of the organization’s would, too. President and CEO was to send post-acute care strategies to reduce unnecessary Western Maryland The board felt that our core Health System the resident, by utilization. These strategies can include: values of integrity, innovation, ambulance, to the • Creating partnerships across the care contin- compassion, accountability, respect, hospital. Often, residents simply uum to better address patient needs and excellence still fit very well with were dehydrated. After receiving • Understanding the social determinants of health our organization’s new direction. We IV fluids, they would be returned that may be affecting the patients served by the amended the mission statement to to the SNF just a few hours later. hospital or health system better reflect the patient-centered Such trips to the ED are physi- • Developing a strategy to address patient needs approach to care delivery in tandem cally and emotionally taxing • Learning from organizations already involved with our intention to improve the health on an already compromised with reducing utilization to discover what and well-being of the community. Since elderly resident, not to mention established strategies can be applied at your the value-based model cares for patients costly because of the ambulance hospital/health system in the most appropriate setting, result- transfer and other resources • Educating the community and other providers ing in less acute care utilization and dedicated to the resident’s on what you will achieve through such significantly more care delivery in pre- diagnosis and treatment. Under strategies and post-acute settings, we changed the value-based care delivery and vision statement to reflect the need to global budgeting, each ED visit create partnerships with other providers constituted unnecessary utilization. care delivery models: that at some point throughout the healthcare continuum. Our goal and need was to make in the not-too-distant future, they too The relationships between WMHS’s patient-centered, value-based care the would risk penalties for overutilization. pre-acute settings and urgent care new norm. We had to move our relation- WMHS leadership continue to meet with providers, independent physician ship from one as a potential competitor the group of SNF leaders every other practices, ambulatory surgery centers, to that of a trusted partner, acting in month and the relationships we have diagnostic centers, and in-home concert for the good of the patient. established continue to mutually benefit providers were well-established. The Early in our value-based care delivery the SNF staff and the health system. goal with those relationships was to journey, we invited leadership from the solidify and enhance them, moving from SNFs to join WMHS leadership in a new relationships to working partnerships. venture called “Partnership to Perfec- However, relationships with post-acute tion.” Establishing trust was paramount “Alone we can do so care settings were more challenging for to this effort. During a series of meet- little; together we many reasons. ings, we focused on key areas beginning can do so much.” with education: we explained our new –Helen Keller Strengthening Relationships care delivery model and our goal to with Post-Acute Care Providers keep patients healthy and out of the hos- There are a dozen skilled nursing pital. Next, we asked for their assistance Collaborating across facilities (SNFs) in the area, including and support. We knew we could not the Care Continuum one of our own that regularly accepts achieve our goals without their coopera- In addition to working with SNFs discharges from the acute care setting. tion. We went on to train the SNF staff to remodel patient care, we quickly Owning one of these SNFs compounded on a variety of treatments that could be recognized that value-based, patient- the challenge of changing the performed in their facilities, placed RN centered care requires partnerships patient care model because it added transitionists, or liaisons between hos- across the continuum. From physicians inherent competition and posed a pitals and SNFs, in their facilities, and in and pharmacies to government entities, variety of trust issues. some locations, replaced their medical the faith-based community, and service For example, a typical scenario at that directors with SNF specialists (similar agencies, such as homeless shelters and time might include a physician with two to hospitalists, exclusively serving SNF senior living centers, we now collabo- positions: an independent practitioner, residents). Finally, we provided educa- rate with a multitude of organizations. primarily, and an SNF medical director, tion regarding the likely direction of GovernanceInstitute.com OCTOBER 2018 • BoardRoom Press 1 When working with these partners, challenging patients has proven for transportation for one of our many our community health workers and effective, with a direct correlation to patients in rural locations, or setting up patient navigators focus on addressing reduced readmissions. remote monitoring in the home. the social determinants of health With the help of our partners, WMHS for recently discharged patients. also has created seven community Partnerships Key to Interventions regularly include gardens throughout our service area Post-Acute Strategy arranging for meals, transportation, to feed victims of food insecurity. In Partnerships with key providers medications, follow-up primary care addition to the community garden plots, continue to be the most essential com- physician appointments, and providing the health system maintains several ponent of our post-acute care strategy. telemonitoring equipment in patients’ plots and donates the harvest to the Our results reflect improved patient homes. Care coordinators follow up local food bank. Fruit trees encircle care and success: We have reduced with every discharged patient, address- some gardens, providing fresh fruit to admissions by 27 percent since 2011, ing any needs that may have arisen. anyone who maintains a plot. readmissions by 26 percent, and ED Care coordinators also are located in The goal of our post-acute care visits by 15 percent. Each improvement physician offices to assist patients with strategy is to provide patients is directly tied to our comprehensive avoiding unnecessary readmissions. with optimal care and for them to post-acute care strategy. Teams of staff make an effort to see remain healthy upon returning to patients in locations close to where they the community. We have learned that The Governance Institute thanks Barry live, including churches, community patient-centered care must be personal- P. Ronan, FACHE, President and CEO centers, shelters, and even municipal ized, intensive, and involve one-on-one of Western Maryland Health System, buildings. These teams arrange for creative engagement. Nothing is “off in Cumberland, MD, for contributing follow-up appointments or find a the table,” whether it be arranging for a this article. He can be reached at primary care practitioner if the patient follow-up appointment with a primary [email protected]. does not have one. Providing transpor- care physician, obtaining medications, tation for some of the most medically providing healthy meals, arranging 2 BoardRoom Press • OCTOBER 2018 GovernanceInstitute.com.
Load more

Recommended publications
  • The Effect of Contact Precautions on Healthcare Worker Activity in Acute Care Hospitals Author(S): Daniel J
    The Effect of Contact Precautions on Healthcare Worker Activity in Acute Care Hospitals Author(s): Daniel J. Morgan, MD, MS; Lisa Pineles, MA; Michelle Shardell, PhD; Margaret M. Graham, MPH; Shahrzad Mohammadi, BS, MPH; Graeme N. Forrest, MBBS; Heather S. Reisinger, PhD; Marin L. Schweizer, PhD; Eli N. Perencevich, MD, MS Reviewed work(s): Source: Infection Control and Hospital Epidemiology, Vol. 34, No. 1 (January 2013), pp. 69-73 Published by: The University of Chicago Press on behalf of The Society for Healthcare Epidemiology of America Stable URL: http://www.jstor.org/stable/10.1086/668775 . Accessed: 17/12/2012 01:25 Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp . JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected]. The University of Chicago Press and The Society for Healthcare Epidemiology of America are collaborating with JSTOR to digitize, preserve and extend access to Infection Control and Hospital Epidemiology. http://www.jstor.org This content downloaded on Mon, 17 Dec 2012 01:25:08 AM All use subject to JSTOR Terms and Conditions infection control and hospital epidemiology january 2013, vol. 34, no. 1 original article The Effect of Contact Precautions on Healthcare Worker Activity in Acute Care Hospitals Daniel J.
    [Show full text]
  • ELECTRICAL GUIDE for HEALTH FACILITIES REVIEW
    ELECTRICAL GUIDE for HEALTH FACILITIES REVIEW HOSPITALS SKILLED NURSING FACILITIES AND CLINICS 2016 Office of Statewide Health Planning and Development Facilities Development Division Revised 3/1/2017 OSHPD 2016 Electrical Guide for Health Facilities Review Forward The Office of Statewide Health Planning and Development (OSHPD) is responsible for enforcing all building standards, codes, and regulations pertaining to hospitals, skilled nursing facilities, and under specific circumstances, clinics in the State of California. The following document was compiled by the OSHPD electrical engineering staff as a guide for plan review to verify compliance and is intended for OSHPD use. All others who use this information for any other purpose do so with the full knowledge that it may not contain every requirement or change in policy and that the requirements are as interpreted by OSHPD. Title 24, Part 3, California Electrical Code, as well as other parts of Title 24, apply in the design and construction of health care facilities. This guide highlights and summarizes the most common requirements encountered in the review of hospitals, skilled nursing facilities, and clinics. This document may not contain every requirement or change in policy and the requirements are as interpreted by OSHPD. All projects submitted on or after January 1, 2016, are subject to the 2016 California Electrical Code (CEC) which is based on the 2014 National Electrical Code (NEC) with the 2016 California amendments. Office of Statewide Health Planning and Development Facilities Development Division www.oshpd.ca.gov 2 | Page Revised 3/1/17 OSHPD 2016 Electrical Guide for Health Facilities Review Table of Contents Plan Submittal Check List ................................................................................................................
    [Show full text]
  • Guidance: Discontinuing Additional Precautions Related to COVID- 19 for Admitted Patients in Acute Care and in High-Risk Outpatient Areas
    Interim Guidance: Discontinuing Additional Precautions Related to COVID- 19 for Admitted Patients in Acute Care and in High-Risk Outpatient Areas May 21, 2021 This guidance is intended for health-care providers working in acute care settings including infection prevention and control; workplace health and safety and public health teams; direct care providers (e.g., physicians, nurse practitioners, nurses); patient access and flow teams; and unit and site leadership. Contents Scope ..............................................................................................................................................................2 Purpose ...........................................................................................................................................................2 How to Use This Document ................................................................................................................................2 Considerations for Determining Duration of Additional Precautions ..................................................................3 Use of a Test-Based Strategy........................................................................................................................4 Definitions of Key Concepts ................................................................................................................................5 General ....................................................................................................................................................5
    [Show full text]
  • United States Ex Rel. Integra Med Analytics, LLC V
    Case 5:17-cv-00886-DAE Document 29 Filed 08/05/19 Page 1 of 17 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TEXAS SAN ANTONIO DIVISION UNITED STATES OF AMERICA ex § No. 5:17-CV-886-DAE rel. INTEGRA MED ANALYTICS, § LLC, § § Plaintiff, § § vs. § § BAYLOR SCOTT & WHITE § HEALTH, BAYLOR UNIVERSITY § MEDICAL CENTER-DALLAS, § HILLCREST BAPTIST MEDICAL § CENTER, SCOTT & WHITE § HOSPITAL-ROUND ROCK, § SCOTT & WHITE HOSPITAL § TEMPLE, § § Defendants. § ORDER GRANTING DEFENDANTS’ MOTION TO DISMISS (DKT. # 21) Before the Court is a Motion to Dismiss filed by Defendants Baylor Scott & White Health, Baylor University Medical Center-Dallas, Hillcrest Baptist Medical Center, Scott & White Hospital-Round Rock, and Scott & White Hospital Temple (collectively “Defendants”). (Dkt. # 21.) Pursuant to Local Rule CV-7(h), the Court finds these matters suitable for disposition without a hearing. After careful consideration of the memoranda filed in support of and in opposition to the 1 Case 5:17-cv-00886-DAE Document 29 Filed 08/05/19 Page 2 of 17 motion, the Court—for the reasons that follow—GRANTS Defendants’ Motion to Dismiss. (Id.) BACKGROUND I. Factual Background Defendants in this qui tam action are the operator of a network of inpatient short-term acute care hospitals and four of its affiliated hospitals. (Dkt. # 151 at 3.) Part of the services Defendants perform are for patients covered by Medicare, and therefore Defendants regularly submit requests to Medicare for reimbursement for these services. (Id.) As such, these request for reimbursement are subject to the False Claims Act (“FCA”), and knowingly presenting false or fraudulent claims to the Government for reimbursement is illegal and incurs civil liability.2 31 U.S.C.
    [Show full text]
  • An Alternative Payment Model for Delivering Acute Care in the Home
    Personalized Recovery Care Program Home Hospitalization: An Alternative Payment Model for Delivering Acute Care in the Home A Proposal to the Physician-Focused Payment Model Technical Advisory Committee From Personalized Recovery Care, LLC October 27, 2017 Personalized Recovery Care, LLC Contact: Narayana S. Murali President/Chief Executive Officer, Marshfield Clinic Health System Hospitals, Inc. Chief Clinical Strategy Officer, Marshfield Clinic Health System 1000 North Oak Avenue Marshfield, Wisconsin 54449 Phone: 715-387-5253 Email: [email protected] Personalized Recovery Care, LLC 1000 North Oak Avenue Marshfield, Wisconsin 54449 October 27, 2017 Physician-Focused Payment Model Technical Advisory Committee C/o U.S. DHHS Asst. Secretary for Planning and Evaluation Office of Health Policy 200 Independence Avenue S.W. Washington, D.C. 20201 [email protected] Cover Letter– Personalized Recovery Care, LLC, Home Hospitalization: An Alternative Model for Delivering Acute Care in the Home Dear Committee Members, On behalf of Personalized Recovery Care, LLC (“PRC”), a joint venture between Marshfield Clinic and Contessa Health, I respectfully submit this proposal for a Physician-Focused Payment Model entitled “Home Hospitalization: An Alternative Model for Delivering Acute Care in the Home” for PTAC review. PRC proposes to launch this model for Medicare Fee-For-Service patients at Marshfield Clinic, with the goal of expanding it to physicians and settings across the country. PRC welcomes the opportunity to engage with PTAC Advisory Committee to test this model where physicians could provide hospital level care delivery to Medicare fee-for-service beneficiaries in their homes for a meaningful number of medical and surgical conditions. PRC is committed to and has demonstrated high quality of care focused on superior outcomes, excellence in patient experience and lower health care costs.
    [Show full text]
  • Interim Guidance for Discharge to Home Or New/Re-Admission to Congregate Living Settings and Discontinuing Transmission-Based Precautions
    MINNESOTA DEPARTMENT OF HEALTH Interim Guidance for Discharge to Home or New/Re-Admission to Congregate Living Settings and Discontinuing Transmission-Based Precautions 6/4/2021 Community transmission of SARS-CoV-2 in Minnesota continues to lead to COVID-19 illness and hospitalizations. Ensuring hospital bed capacity for individuals who require acute care is directly related to the ability to discharge COVID-19 patients to settings equipped to provide appropriate care while maintaining the safety of other vulnerable residents. Minnesota Department of Health (MDH) recommends that patients with suspected or confirmed COVID-19 be discharged when clinically indicated. Discontinuation of Transmission-Based Precautions nor negative COVID-19 test results are not required prior to hospital discharge.1 This guidance addresses discharging hospital inpatients or congregate living settings residents to home or congregate living settings. This guidance also addresses discontinuation of Transmission-Based Precautions in hospitals and congregate living settings. Congregate living settings include assisted living and skilled nursing facilities, or other congregate living settings that provide direct care. All facilities providing health care should address source control,2 eye protection, and staff monitoring and exclusion policies.3 Discharge of an inpatient or resident to home Patients or residents with confirmed or suspected COVID-19 can be discharged to home when it is clinically indicated. These recommendations are relevant when no additional health services are needed and when ongoing home health care (e.g., skilled nursing, physical therapy, occupational therapy, speech therapy, social work) is appropriate. Home isolation can be discontinued following a symptom-based strategy.1 . Caregivers should be educated on care procedures and visitation restrictions in the home for confirmed or suspected COVID-19 patients.4 .
    [Show full text]
  • The Importance of Home and Community-Based Settings in Population Health Management
    The importance of home and community-based settings in population health management Nathan Cohen Dieter van de Craen Andrija Stamenovic Charles Lagor Philips Home Monitoring March 2013 Philips Healthcare 2 Furthermore, the new strategies require Executive Summary technologies to support health care providers in delivering population health. This paper is the first of a series of white papers that Philips has published on population health management. It provides a summary of the The Cost, Quality and Access implications of the health care reform on the financial risks being placed on healthcare Conundrum providers in the United States. It emphasizes Managing Chronic Disease the importance of the home and community- based settings in population health The growth in health expenditures is driven by management. In doing so, it sets the stage for multiple factors. One critical factor is the rising other white papers that describe actual incidence of chronic diseases, which the approaches to leverage remote health Centers for Disease Control and Prevention has management offerings for population health estimated now account for 75% of the cost of management. medical care. Patients with Chronic disease make up only 20% of Medicare patients yet account for 80% of expenditures. These Introduction patients have higher rates of unnecessary hospital admissions and take many Health care expenditures have been rising medications to manage their conditions. unsustainably across the globe. Alone in the Traditional fee-for-service payment models United States, for example, health care that pay for treatment transactions are ill- expenditures in 2010 reached $2.6 trillion, over suited for serving patients that require close ten times the $250 billion expended in 1980.
    [Show full text]
  • Chapter 7—Acute Care Inpatient/Outpatient Hospital Services Chapter 7: Acute Care Inpatient/ Outpatient Hospital Services
    Chapter 7—Acute Care Inpatient/Outpatient Hospital Services Chapter 7: Acute Care Inpatient/ Outpatient Hospital Services Executive Summary Description Acute care hospitals are the largest group of enrolled hospital providers. Kansas Medicaid has 144 acute care hospitals, 5 state institutions, 5 rehabilitation hospitals, and 3 psychiatric hospitals en- rolled within the state. Over 540 similar out-of-state hospitals are also enrolled. All but nine of Kansas 105 counties have an acute care hospital: two-thirds of those (68) have just one. Most in- patient hospitals are reimbursed based on diagnosis related groups (DRG) with rates that vary as a proportion of Medicare. Outpatient hospitals are reimbursed as fee-for-service. Key Points In 2005, legislation funded a DRG rate increase through a hospital provider assessment. Overall spending on inpatient services has increased each year. The majority of top DRGs by reimbursement are related to births and the majority of reim- bursements based on procedure codes are related to the emergency room visits. KHPA updates the DRGs and realigns (but does not increase overall) payment rates each year with the annual Medicare DRG updates. However, KHPA frequently receives the DRG updates late in the year making it difficult to implement them by January 1, resulting in administrative challenges. In 2007, Medicare’s payment update included a significant adjustment in many DRG rates, along with the addition of many new DRGs, to better reflect the true costs of care in general versus specialty hospitals. KHPA was not able to make these changes in 2007, but is planning to incorporate these more significant changes in January 2009.
    [Show full text]
  • Introduction of a Psychiatric Acute Care Clinic Into a Metropolitan Jail
    Introduction of a Psychiatric Acute Care Clinic into a Metropolitan Jail JOHN PETRICH. M.D.- Introduction Mentally ill individuals continue to be housed in metropolitan .jails to await trial or to serve short sentences'! Such patients frequently present seriom in-.jail management prob­ lems because of suicidal. assaultive and disruptive beha\"ior.~ A recent study estimated psychiatric morbidity in a metropolitan .jail to be 4.fi%.~ The majority of those patients suffered from psychotic psychiatric syndromes. Facilities for in-jail psychiatric treatment are seldom available.4 Out-of-jail facilities are resistant to providing services to prisoners.1i The literature on treatment of mentally disordered offenders describes prison.6-11 hospital!:! and outpatient program~!3. H which offer forensic. long-term care or rehabili­ tative therapy. No descriptions of programs designed to provide acute psychiatric care to jailed patients. except in the context of forensic programs.la could be identified. Community-oriented short-term hospitalization and crisis service\ are gaining wide acceptance in general psychiatric practice.1fl. 17 These techniques are considered to pro­ vide effectivelH• 19 and ecollomical21l treatment for most acute psychiatric disorders. They can be adapted to serve highly mobile and severely disturbed patients.!!1 Such approaches could be utilized to meet the psychiatric aCllte care needs of a metropolitan jail population. This paper describes the developmcnt and operation of a jail-based aCllte care psychi­ atric clinic which provides short-term and crisis-oriented psychiatric treatment and referral services fOT inmates suffering from psychotic iIlnc\\es and severe situational reactions. Method . The combined Seattle City and King County Jail facilitie~ prmide detention for indi­ VIduals arrested on felony and misdemeanor charges in King COUllty, 'Vashington, which has a population of I.
    [Show full text]
  • Evidence for Overuse of Medical Services Around the World
    Series Right care 1 Evidence for overuse of medical services around the world Shannon Brownlee, Kalipso Chalkidou, Jenny Doust, Adam G Elshaug, Paul Glasziou, Iona Heath*, Somil Nagpal, Vikas Saini, Divya Srivastava, Kelsey Chalmers, Deborah Korenstein Lancet 2017; 390: 156–68 Overuse, which is defined as the provision of medical services that are more likely to cause harm than good, is a Published Online pervasive problem. Direct measurement of overuse through documentation of delivery of inappropriate services is January 8, 2017 challenging given the difficulty of defining appropriate care for patients with individual preferences and needs; overuse http://dx.doi.org/10.1016/ can also be measured indirectly through examination of unwarranted geographical variations in prevalence of S0140-6736(16)32585-5 procedures and care intensity. Despite the challenges, the high prevalence of overuse is well documented in high-income This is the first in a Series of four papers about right care countries across a wide range of services and is increasingly recognised in low-income countries. Overuse of unneeded See Comment pages 101, 102, services can harm patients physically and psychologically, and can harm health systems by wasting resources and and 105 deflecting investments in both public health and social spending, which is known to contribute to health. Although Lown Institute, Brookline, MA, harms from overuse have not been well quantified and trends have not been well described, overuse is likely to be USA (S Brownlee MSc, increasing worldwide.
    [Show full text]
  • Out of the Straitjacket. Michael Weinstein Thomas Jefferson University, [email protected]
    Thomas Jefferson University Jefferson Digital Commons Department of Surgery Faculty Papers Department of Surgery 3-1-2018 Out of the Straitjacket. Michael Weinstein Thomas Jefferson University, [email protected] Let us know how access to this document benefits ouy Follow this and additional works at: https://jdc.jefferson.edu/surgeryfp Part of the Mental and Social Health Commons, and the Surgery Commons Recommended Citation Weinstein, Michael, "Out of the Straitjacket." (2018). Department of Surgery Faculty Papers. Paper 154. https://jdc.jefferson.edu/surgeryfp/154 This Article is brought to you for free and open access by the Jefferson Digital Commons. The effeJ rson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The ommonC s is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The effeJ rson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Department of Surgery Faculty Papers by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. PERSPECTIVE Friction in the Path to Use of Biosimilar Drugs 2016, and growth in spending has From the Department of Health Care Policy, comments on its guidance for industry on Harvard Medical School, Boston. the “nonproprietary naming of biological been averaging 10% per year re- products; draft guidance for industry; avail- cently. Thus, competition creates 1 . IQVIA Institute for Human Data Science.
    [Show full text]
  • Regulatory Overload
    Regulatory Overload Assessing the Regulatory Burden on Health Systems, Hospitals and Post-acute Care Providers Analytics and research support provided by October 2017 Regulatory Overload: Assessing the Regulatory Burden on Health Systems, Hospitals and Post-acute Care Providers Table of Contents Executive Summary 3 I. Introduction 7 II. Research Scope and Methodology 9 III. Assessing the Impact of Regulatory Compliance on Providers and Patients 12 A. Nationally, health systems, hospitals and PAC providers spend nearly $39 billion on the administrative aspects of regulatory compliance. 13 B. Physicians, nurses and allied health staff make up over one-quarter of the FTEs dedicated to regulatory compliance, pulling clinical staff away from patient care responsibilities. 14 C. Documenting conditions of participation adherence and billing/coverage verification processes are the most burdensome of the nine domains. 14 • Hospital CoPs 15 • Billing and coverage verification requirements 16 D. Quality reporting requirements are often duplicative and have inefficient reporting processes, particularly for providers participating in value-based purchasing models. 18 • Quality reporting requirements create duplication of effort and inefficiency, with unknown patient benefit. 18 • The quality reporting burden is magnified by participation in new models of care/value- based purchasing models. 19 E. Fraud and abuse requirements are outdated and have not evolved to support new models of care, in some cases compromising access to care. 20 F. Meaningful use has spurred provider investment in IT systems, but exorbitant costs and ongoing interoperability issues increase provider burden. 22 G. The timing and pace with which regulations are released make regulatory compliance challenging and generate additional burden.
    [Show full text]