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Value-based Purchasing

Medicare reimbursement is changing. On October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will begin value-based purchasing (VBP), a three-year-plus phased implementation plan under which incentives will be paid to top performers. These incentives will be based on quality measures performance, not just reporting. Organizations that do not meet specified performance standards will lose reimbursement.

To ensure maximum CMS reimbursement, hospitals and health systems need to proactively assess current performance and identify quality improvement opportunities now. Premier is well-equipped to provide hospitals and health systems with the tools and services needed to succeed in a VBP environment. Through analytics tools and insights gathered in its pay-for-performance (P4P) initiatives, Premier offers hospitals and health systems the experience needed to improve quality and succeed with VBP.

HQID and Premier’s P4P leadership

Premier has been at the forefront of P4P since 2003, when Premier teamed with CMS to create the Hospital Quality Incentive Demonstration (HQID), a first of its kind initiative to determine whether financial incentives are effective at improving the quality of inpatient hospital care. More than 260 hospitals have voluntarily participated in the project, which has been extended for an additional three years (through 2009). Results from the first two years of the HQID show that even modest incentives yield improved quality of care, as hospitals have consistently improved performance. Overall quality (based on delivery of 30 nationally standardized care measures) rose 11.8 percent among participants in the first two years.

The success of the Premier/CMS HQID project has been recognized by health authorities in the United Kingdom. The National Health Service North West region – England’s largest strategic health authority – will be using the project as a guideline for its own P4P program.

Learn more about the Premier/CMS HQID:

QUEST

QUEST: High Performing Hospitals, a program of the Premier healthcare alliance, takes P4P to the next level of performance. Building on the success of the Premier/CMS HQID, QUEST will develop the next generation of quality, safety and cost metrics with a consistency and standardization that does not exist today.

QUEST overview

Performance Pays

Building on early findings from the HQID project, which showed dramatic quality improvements across the board, Premier undertook an additional, extensive analysis of the HQID results to examine the relationship between quality and cost. The findings indicate that better patient care costs hospitals less and improves patient outcomes.

Learn more about the study and its findings:

Premier Informatics products/services

Premier helps hospitals accurately gauge performance and identify valid improvement opportunities through its Performance Suite. The suite offers Web-based tools that integrate quality and safety, labor management, and supply chain channels to help hospitals make better decisions about how to improve the overall quality of care while safely reducing costs.

Premier products that help hospitals and health systems prepare for anticipated reimbursement changes include:

ClinicalAdvisor

Analyze clinical performance with the best-in-class clinical efficiency and quality performance benchmarking tool, empowering data-driven decision making.

Performance Improvement Portal

Join Premier's dynamic online community of industry specialists, hospital and health system peers and Premier's knowledge experts. Access Premier's library of clinical, operational and financial best practice tools, templates and methodologies gleaned from the nation's top performing hospitals.

Quality Manager

Fine-tune the delivery of care and reduce costly avoidable patient events.

Quality Measures Reporter

Submit and analyze core measures data for national and state regulatory compliance and P4P reimbursement.

Performance Partner Program

Engage Premier’s partners and performance engineers to provide on-site, customer-focused performance improvement expertise to drive high quality, cost-effective patient care.

Premier Consulting Solutions

Work with Premier’s experienced consultants to achieve clinical, financial, and operational performance breakthroughs with insights and analysis gleaned from the Premier Performance Suite.

Tools/services overview

Learn more about the products and services available in the Premier Performance Suite; access to case studies and product demos.

Premier Advocacy

Premier's Advocacy team raises the national voice of non-profit hospitals on Capitol Hill to influence the outcomes of legislative and regulatory initiatives, and promote an environment through which the alliance will transform healthcare.

Premier participation in Senate Finance Roundtable on VBP

P4P position statements

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Nexus is designed to provide valuable information and insights into how hospitals and healthcare professional are improving care processes and implementing innovative programs to save lives and reduce costs. Each issue explores current topics engaging Congress, the administration and others in healthcare policy.