This is the final part or a four-part series on the value-based purchasing (VBP) program.
In Part 1 of our series, we looked at what led to the program. Part 2 shared an examination of the final rule issued by the Centers for Medicare and Medicaid Services (CMS). Part 3 reviewed the impact anesthesia services has on the VBP program.
In this final installment, we explore how anesthesia services can assist hospitals with compliance efforts.
Shift in Focus
The VBP program is a monumental shift in focus for hospitals. An outcomes-based business model replaces the traditional volumes-based approach. With the increased emphasis on quality and its impact on future reimbursements, an effective quality improvement program is essential for a hospital’s survival.
The measurement for the VBP program is a composite of outcomes, patient safety and experiences. If hospitals want the opportunity for retrieving any portion of its contributions to the VBP fund, it needs a quality improvement program with tracking, measuring and reporting capabilities.
Its program must lay a foundation for compliance, not only with the VBP program, but with all state and federal regulatory requirements, as well as the facility’s bylaws. Additional quality improvement elements include accreditation requirements and compliance with professional standards, benchmarks and practice parameters.
A hospital’s clinical quality should measurably capture and improve upon the performance, processes and outcomes associated with each patient’s health care experience. With the operating room as its center, hospitals will need a quality improvement program that focuses on clinical excellence and operational effectiveness. Anesthesia can assist with that.
Anesthesia’s integration throughout the continuum of a patient’s care in most surgical, procedural and obstetrical areas offers a partnership that makes sense for developing the quality controls and measurements for compliance.
Clinical standards build on the compliance foundation with evidence-based medicine, accreditation, benchmarking and best practices. Such standards meet outcomes and patient safety requirements. Quality-driven documentation satisfies reporting requirements and enhances quality improvement efforts. The critical and comprehensive role of anesthesia in the delivery of care has a significant impact on compliance.
Holding anesthesia accountable for initiatives such as, patient surveys, outcomes tracking and audits puts the responsibility on a provider who has a constant presence in the assessment and management of the patient’s care. That insight helps hospitals establish a comprehensive quality improvement program that not only meets requirements, but also provides clinical quality excellence.