Queen Hospital ended the fiscal year with a 3% reduction in reimbursement for its Medicare patients. The medical board is not pleased with the reduction and is planning to cut down on hospital expenses to recoup the lost revenue. However, the medical board would also like to determine a plan of action to increase the next fiscal year's reimbursement rate. The board has called a committee meeting to discuss a plan of action and invited you, the Quality Improvement Manager, as they know Medicare reimbursement is tied to quality. To prepare for the meeting, you decide to create a report to distribute to the meeting's attendees. The report aims to provide helpful information regarding quality measures and reimbursement models to assist the committee members in developing a proper plan of action. The report will include information on performance metrics used in performance-based payment models, data used for benchmarking and trending, and medical error reporting. You inform the CFO of your plan to create the report. The CFO is also attending the committee meeting and has asked you to include information on the Hospital Value-Based Purchasing Program and the Hospital Readmission Reduction Program.

Instructions

Create a professional report to distribute to the committee meeting attendees that:

• Compares the performance metrics for the Hospital Value-Based Purchasing Program and Hospital Readmission Reduction Program.
  • Details on the benefits to improving healthcare performance for each program.
• Interprets the data to collect and use for internal quality benchmarking and trending based on the requirements of the performance-based payment models.
• Examines the medical error reporting and its impact on Medicare and insurance reimbursement.