Thursday, December 18, 2014

The Quality Initiative and Its Impact on Your Overall Business


Everyone has been working hard on the Quality Initiative goals:  1) safely reduce hospital readmissions; 2) increase staff stability; 3) increase customer satisfaction; and 4) safely reduce the off-label use of antipsychotics.  We have seen many examples of success – this is great and continued improvements are important because of changes we are going to experience beginning in 2015.  What are the changes and what do the Quality Initiative goals have to do with them?

Five-Star: (a) Antipsychotic use will be added to the Quality Measure (QM) domain early in 2015; (b) measures for return to hospital and discharge to community will be added to the QM domain later in the year; (c) submission of electronic payroll data will begin on a voluntary basis in 2015; (d) CMS will implement other processes to validate reported staffing information.

IMPACT Act: Data about quality measures, hospitalizations, rehospitalizations, and discharge to community must be reported publicly and made available to consumers when transitioning to long term care.  This data reporting is phased in between October 2017 and October 2019.  Penalties for not meeting the reporting requirements begin in October 2019 and will be a market basket payment penalty of 2 percent.

Value-Based Purchasing: Beginning in October 2018, Medicare payment rates will be based in part on a nursing centers’ performance scores related to an all-condition hospital readmission measure.  This measure must be developed by October 2015.  And by October 2016, an all-condition risk-adjusted potentially preventable hospital readmission rate will be developed. 


These are just three examples of the value of embracing the Quality Initiative and striving to achieve and sustain the goals.  

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