The ACA created several value-based payment mechanisms, some of which are set to begin this October. Along with new conditions for the hospital readmission penalty program is an addition to the Hospital Value-Based Purchasing Program that hold hospitals accountable for spending on episodes of care that include pre- and post-acute services.
The Medicare Spending Per Beneficiary (MSPB) measure includes spending occurring during the 30 days post-hospital discharge, making PAC a significant contributor to hospitals' scores. This emphasis on managing episodes of care forces hospitals to pay closer attention to patients’ post-discharge care and encourages them to work more collaboratively with PAC providers.
Sally identifies three VBP-based strategies for PAC providers to take advantage of this opportunity:
CMS published hospitals' 2012 MSPB results, making it easy to see how different referring hospitals' compare, making it easy to know which hospitals will be penalized. Demonstrating an understanding of this information in the broader context of VBP will ultimately help PAC providers secure mutually beneficial partnerships.
- Know the score. Know the referring hospitals' MSPB scores and know whether they will be penalized or rewarded this year.
- Bring Market Intelligence. The hospital's PAC spending efficiency is related to three things: readmissions, skilled nursing facility length of stay, and the use of high-cost PAC settings. Come prepared with suggestions for the hospital's opportunity to improve in collaboration with you as a strategic partner.
- Demonstrate Your Efficiency. Present an efficiency and quality story. Even if you have a higher length of stay, explain how your care can prevent readmissions.
View Sally’s full blog post.