Problem

How will I demonstrate my pay for performance capabilities?

Our consultants provide a step-by-step process to leverage results and gain market share and improve clinical outcomes.

Scroll to See How

Step 1: measure outcomes

CATEGORIES AND RATINGS

RATED ON A SCALE OF

  • 6

    Independent

  • 5

    SET-UP / CLEAN-UP ASSIST

  • 4

    SUPERVISION

  • 3

    PARTIAL / MODERATE ASSIST

  • 2

    SUBSTANTIAL ASSIST

  • 1

    DEPENDENT

Step 2: measure quality

Quality Measures: 5 Star & Survey

Medicare.gov Nursing Home Compares:

What information can I get about Quality Measures?

What are the 5 star quality ratings?

About Nursing Home inspections?

Step 3: measure REHOSPITALIZATIONS

KNOW YOUR NUMBERS

The government has started to publish all skilled nursing home readmission rates on Nursing Home Compare.

HOW TO TRACK A READMISSION

Collecting and analyzing the right data

HERE’S WHAT HAPPENS WHEN DATA IS OVERLAID

MARKET SHARE

KNOW THE PLAYING FIELD

Hospitals are seeking to hold post-acute-care providers accountable because they have more at risk under value-based payment models.

How big is your piece of the pie compared to your competition?

Questions to ask yourself:
  • Checklist

    How many Medicare days do you have compared to your competition?

  • Checklist

    What is your admission rate by diagnosis?

  • Checklist

    How much revenue do you have compared to your competition?

  • Checklist

    What percentage of HMO business do you have compared to your competition?

  • Checklist

    How many direct competitors do you have and do you know who they are?

  • Checklist

    Who is your hospital sending patients to?

  • Checklist

    What percentage of the hospital discharges are you getting?

  • Checklist

    What is your LOS compared to the competition?

  • Checklist

    What is your LOS by payer? By Medicare? By HMO? By Medicaid/VA?

  • Checklist

    Have you done anything in the last few years to affect your market share? Can you demonstrate where you moved the needle?

  • Checklist

    Do you know your cost by diagnoses (Rx and Rehab)?


Summary

Consulting provides the keys to demonstrating pay for performance capabilities