Payment for performance: Getting the carrot not the stick

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Inpatient and ancillary services

Jamie Jenkins
Premier Performance Engineer
Premier located at Central Baptist Hospital

Tina Bridges
Premier for Western Baptist Hospital

As participants in CMS's hospital quality demonstration (HQID) project, Central Baptist and Western Baptist have shown measurable improvement in care delivery to patients in five clinical conditions: AMI, CABG, pneumonia, hip and knee, and heart failure. Central got the carrot of increased reimbursements. Come and learn how we did it.

Central Baptist and Western Baptist Hospitals are representing the five-hospital Baptist Healthcare System in the HQID Project. Both hospitals have shown measurable improvements in patient care. We will show how we achieved these results.

Each quarter abstracted data from the hospitals are sent to Premier for patients in the five clinical conditions. Premier then sends that data to CMS and produces reports for all hospitals participating in the project using their clinical advisor database. We will review each hospital's reports for the first two years of the project. We will explain how we achieved improvements using physician champions, improvement teams, standardized order sets, education, and other techniques.

We will discuss the carrot and stick approach used by CMS for the project. Central received added reimbursement in hip and knee and pneumonia for year two. We will describe decile performance and the funds the hospital is due to receive.