In our previous blog we introduced the new CMS guidelines for Medicare reimbursements to hospitals. As promised, here is some more clarification as to how your voice will be heard.

Hospitals created their baseline for performance in 2009/2010. The results of their surveys (HCAHPS) from patients who evaluated their experience set the baseline for their Value Based Purchasing (VBP) measure. Hospitals are now in their “performance period,” which started on July 1, 2011 and extends through March 31, 2012. A hospital will get points for how well they treated their patients (as indicated on the patient’s survey), as compared to other hospitals and as compared to their baseline period scores. This creates a huge incentive for hospitals to provide a great experience for their patients.

The ratings will be based on the list in our previous email, and covers things such as how well the nurse and doctor listened to you. In addition, such things as how well your pain was treated, and how prepared you were for your discharge home are evaluated.

Hospitals and the professionals in them take the care of the patient quite seriously. Their first priority is to keep you safe and get you well, how well they do this is measured by the clinical outcome criteria (some of which was mentioned in the previous blog). In addition, they must be respectful and comforting, clear in their communications with you, and listen well to you.

None of us like to pay for services that are sub-par, and in essence this is what will be happening with Medicare payments to hospitals. Hospitals that are not providing great care, will not receive full funding.

We hope this provides some clarity to this rather complicated topic. We would love to hear your thoughts on this topic. Is it a step in the right direction?

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