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Value-Based Care

Value-Based Care

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Value-Based Care

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  1. Value-Based Care Value Based Quality & Safety Lecture d – Patient Experience This material (Comp 23 Unit 5 was developed by the University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0007. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit

  2. Patient ExperienceLearning Objectives • Understand and define what is patient experience • Describe how patient experience dictates quality • State the factors identified as key to a positive patient experience • Learn what the HCAHPs survey measures • Recognize how HCAHPs are linked to hospital reimbursement

  3. Provider-Centered Care Source: (Cartoon. Sunday, August 2, 2015, Medical Funnies, AHRQ, 2011)

  4. Definition: Patient Experience

  5. Paradigm Shift Source: (National Research Council, 2001. Barry and Edgman-Levitan, 2012. IHI, 2015.)

  6. Patient Experience and Quality • Research shows that positive patient experiences have a well-documented relationship to clinical quality • Key element of the National Quality Strategy Source: (FamiliesUSA, 2014. DHHS, 2011)

  7. Positive Patient Experience • Hospitals with high levels of ‘patient care experience’ reported by patients provide clinical care that is higher in quality across a range of conditions. • Objectively measured health outcomes • Adherence to medications and treatments • Health resource usage • Technical quality of care & adverse events Source: (Doyle et al, 2013)

  8. Transparent Patient Experience Reporting • Healthcare Effectiveness Data and Information Set (HEDIS) • Consumer Assessment of Healthcare Providers and Systems program (CAHPS) • Patient-Centered Outcomes Research Institute (PCORI) • Last several years has seen a raise in the number of web sites on which patients/consumers can provide subjective ratings of care they have received Source: (AHRQ, 2011)

  9. What Matters To Patients • Feeling informed and being given options • Staff who listen and spend time with me/patients • Being treated as a person, not a number • Being involved in care and being able to ask questions • The value of support services, for example patient and care support groups • Efficient processes Source: (Robert et al., 2011, Teunissen et al., 2013)

  10. Patient and Family-Centered Care (PFCC) • Respect and Dignity • Information Sharing • Participation • Collaboration Source: (Lewis, 2013)

  11. Changing the “Care Experience” Source: (Lewis, 2013)

  12. CMS CAHPS Surveys • Consumer Assessment of Healthcare Providers and Systems • CAHPS for Hospital, Home Health, Hospice • CAHPS for ACOs Participating in CMS Initiatives • Health plans and providers may modify survey Source: (AHRQ)

  13. Survey Characteristics • Not a satisfaction survey • Measures the behaviors of staff from the patients’ perspective • Patient mix adjusted (age, health, medicine, surgery, OBS) • Not limited to Medicare patients • Nursing and Physician based questions • Incentivized by the Inpatient Prospective Payment System and the ACA Source: (

  14. CAHPS and Value-Based Care Source: (CMS)

  15. Patient Experience Summary – Lecture d • The industry attention has shifted to better recognizing that patient experience is critical • Positive patient experience consistently associated with better care outcomes • Patients value being respected and treated with dignity • HCAHPs survey is one tool used to assess patient experience • Substantive financial reimbursement linked to patient experience

  16. Value-Based Quality and SafetyReferences – lecture d References Aligning Forces for Quality, Good for Health Good for Business: The Case for Measuring Patient Experience of Care (Washington: AFQ), available online at Baker, A. (2001). Crossing the quality chasm: A new health system for the 21st century. BMJ, 323(7322), 1192. Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making--pinnacle of patient-centered care. The New England journal of medicine, 366(9), 780-781. Retrieved from at UAB Lister Hill Library on January 29, 2016. Bisognano M, IHI Quality Improvement Symposium in Orlando Florida December 8, 2015. Centers for Medicare & Medicaid Services, Baltimore, MD. Retrieved on January, 29, 2016. Cleary, P. D. (1999). The increasing importance of patient surveys: Now that sound methods exist, patient surveys can facilitate improvement. BMJ : British Medical Journal, 319(7212), 720–721. Department of Health and Human Services, 2012 Annual Progress Report to Congress: National Strategy for Quality Improvement in Health Care (Washington: HHS, August 2012), Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 2013;3:e001570. doi:10.1136bmjopen-2012-001570 Families USA Issue Brief. Measuring Health Care Quality: An Overview of Quality Measures. (May 2014) p. 7

  17. Value-Based Quality and SafetyReferences 2 – lecture d References “Health Policy Brief: Public Reporting on Quality and Costs,” Health Affairs, March 8, 2012. Retrieved on 02/10/16. Lewis, E. H. (2013). A Culture Shift: Principles and Values of Patient and Family-Centered Care: Changing the Patient and Provider Experience. Anesthesia & Analgesia, 116(6), 1191-1192. Linking Quality to Payment National Quality Strategy. p.18 Robert G, Cornwall J, Brearley S, et al. What matters to patients; developing the evidence base for measuring and improving the patient experience. A report for the Department of Health and NHS Institute for Innovation and Improvement. NHS Institute for Innovation & Improvement, 2011.. Spath, P.L. (2013). Introduction to healthcare quality management 2ed. Chicago: AUPHA/HAP, p. 43. Teunissen, G. J., Visse, M. A., de Boer, W. I., & Abma, T. A. (2013). Structuring patient advocates’ appraisal and evaluation of health research and quality of care. Journal of Participatory Medicine, 5, e16. The Beryl Institute. Retrieved from Images Slide 3: Cartoon. Sunday, August 2, 2015, Medical Funnies, Posted by Helen Killeen BauchMcHargue at 2:46 PM. Retrieved from Slide 11: The Beryl Institute. Slide 14: Improving patient experience.

  18. Value-Based Care Value-Based Quality and SafetyLecture d This material was developed by the University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0007.