Press Ganey and Medicare?

[nowIamRN]

OK. So I was talking to a friend of mine the other day. She works at one of the local hospitals and during one of their staff meetings, they were informed by the manager that somewhere down the line (2015-2020?), Medicare would base their reimbursement on the Press Ganey scores of their patients. I have never heard about something like this before and I just wanted to know if anybody has heard about this and if it is true? and if it is indeed true, what are your thoughts? Do you think it is a great idea or just plain crazy/stupid?

[BluegrassRN]

Not based on Press Ganey, but rather on the HCAHPS survey results. According to my supervisor, hospitals are looking at a 2% reduction in reimbursements based on poor survey scores.

We have a lot of "interventions" and scripting now based on getting higher survey results. Many of our nurses just flat out tell people on discharge "If you're really, truly happy with the care you received, and someone calls to survey you, if you don't chose the "always" option, we don't get any credit for it. So if you think we did a good job and you want to tell them so, choose the "always" option on the survey."

[Old.Timer]

Google Accountable Care Organizations.

Here is link to pdf of FAQ from CMS site.

https://www.cms.gov/OfficeofLegislation/Downloads/AccountableCareOrganization.pdf

This document states that the program will be "in place" by 1/1/12. A performance period is based on a minimum of three years so 2015 would be the first disbursement.

Medicare "Accountable Care Organizations"

Shared Savings Program - New Section 1899 of Title XVIII

Preliminary Questions & Answers

CMS/Office of Legislation

The Affordable Care Act (ACA) improves the health care delivery system through incentives to enhance quality, improve beneficiary outcomes and increase value of care. One of these key delivery system reforms is the encouragement of Accountable Care Organizations (ACOs). ACOs facilitate coordination and cooperation among providers to improve the quality of care for Medicare beneficiaries and reduce unnecessary costs. This document provides an overview of ACOs and the Medicare Shared Savings Program.

[sistasoul]

Yes,

I have heard about this. It is setting up the hospitals and staff for failure. First off, there is no credit given for a 99 percent. It has to be a 100 percent all of the time. Any fool knows that no one can be perfect.

[tntrn, ASN, RN]

Does anybody but me just shake their heads about where health care if going?

[TraumaJunkie2010]

In a recent staff meeting my manager told our unit that in 2012 patient satisfaction is going to become a core measure.

[Old.Timer]

Yes,

I have heard about this. It is setting up the hospitals and staff for failure. First off, there is no credit given for a 99 percent. It has to be a 100 percent all of the time. Any fool knows that no one can be perfect.

I think credit should be received if the percentage is above Medicare's average of paying claims correctly on the first submission. That would be easy to accomplish. :)