HCAHPS: Pay-for-Performance and Value-Based Purchasing
Hours: 1.00
Clinicians need to be well informed about current healthcare policies and regulations, and how changes impact reimbursement and clinical practice. Pay-for-performance (P4P) will continue to be the predominate model for healthcare reimbursement. The Affordable Care Act (ACA) of 2010 established the hospital value-based purchasing program (VBP), which is an initiative from the Centers for Medicare & Medicaid Services (CMS) to incentivize acute care hospitals to improve clinical outcomes and lower the costs of care (CMS, 2021a). The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized patient experience survey and core component of VBP and P4P.
The goal of this course is to equip healthcare professionals with knowledge of the fundamentals of HCAHPS and how HCAHPS scores impact hospital reimbursement as a component of VBP and P4P initiatives.
Clinicians need to be well informed about current healthcare policies and regulations, and how changes impact reimbursement and clinical practice. Pay-for-performance (P4P) will continue to be the predominate model for healthcare reimbursement. The Affordable Care Act (ACA) of 2010 established the hospital value-based purchasing program (VBP), which is an initiative from the Centers for Medicare & Medicaid Services (CMS) to incentivize acute care hospitals to improve clinical outcomes and lower the costs of care (CMS, 2021a). The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized patient experience survey and core component of VBP and P4P. The goal of this course is to equip healthcare professionals with knowledge of the fundamentals of HCAHPS and how HCAHPS scores impact hospital reimbursement as a component of VBP and P4P initiatives.
California Board of Registered Nursing
Provider approved by the California Board of Registered Nursing, CEP# 13791
Nurses will receive 1.00 contact hours for participating in this course.
American Nurses Credentialing Center
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Nurses will receive 1.00 Nursing Contact Hours after successfully completing this course.
Accreditation Council for Continuing Medical Education
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Relias LLC designates this enduring activity for a maximum of 1.00 AMA PRA category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
District of Columbia Board of Nursing
District of Columbia Board of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
Florida Board of Nursing
Florida Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Georgia Board of Nursing
Georgia Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
South Carolina Board of Nursing
South Carolina Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
West Virginia Board of Registered Nursing
West Virginia Board of Registered Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
New Mexico Board of Nursing
New Mexico Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Arkansas State Board of Nursing
Arkansas State Board Of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
Kentucky Board of Nursing
Kentucky Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Mississippi Board of Nursing
Mississippi Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
North Dakota Board of Nursing
North Dakota Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Florida Board of Medicine
Florida Board of Medicine (CEBroker Provider #50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™.
Ohio State Medical Board
State Medical Board of Ohio (CEBroker Provider #: 50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™.
Louisiana State Board of Medical Examiners
Louisiana State Board of Medical Examiners (CEBroker Provider #: 50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™.
Mississippi State Board of Medical Licensure
Mississippi State Board of Medical Licensure (CEBroker Provider #: 50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™.
New Mexico Medical Board
Physicians will receive 1.00 AMA PRA category 1 Credits™.
South Carolina Board of Medical Examiners
South Carolina Board of Medical Examiners (CEBroker Provider #50-290)
Tennessee Board Of Medical Examiners
Tennessee Board of Medical Examiners (CEBroker Provider #50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™
Accreditation Council for Pharmacy Education
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Type Activity: Knowledge
Target Audience Designation: P
ACPE Universal Activity Number: JA4008266-0000-21-086-H04-P
Florida Board of Pharmacy
Florida Board of Pharmacy (CEBroker Provider #50-290)
This module is approved for 1.00 contact hours.
Describe HCAHPS, including the purpose, domains, and scoring.
Describe pay-for-performance and value-based purchasing initiatives and the current state of these programs as they apply to the acute care setting.
Describe the implications of HCAHPS on hospital reimbursement associated with value-based purchasing.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: Background of HCAHPS
History
Current State
HCAHPS Changes Over Time
Proposed Future Changes
2021 Survey Questions
Proposed Questions
Thought Exercise
Survey Regulations
Survey Measures
Survey Ratings
CMS Star Rating
The Impact of COVID-19
Section 3: Hospital Reimbursement Models
Fee-For-Service
Value-Based Care
Additional Value-Based Programs
P4P Advantages and Disadvantages
Implications for Clinical Practice
Clinical Leadership’s Role
Care Coordination
Summary
Section 4: Review
Section 5: Conclusion
Course Summary
Course Contributors
Resources
References
Deborah K. Zastocki, DNP, Ed.M. MA, RN, retired NEA-BC, FACHE(r) is currently founder and president of Legacy Healthcare Management Consulting in North Carolina. She received her BSN from the University of Rhode Island, both master's degrees from Teachers College Columbia University, and her DNP from the University of Medicine and Dentistry of NJ. Dr. Zastocki has over 30 years of experience, with a professional career that included a journey from staff nurse to nurse executive roles, authorship, adjunct faculty, and healthcare executive leadership. Dr. Zastocki is the former president and CEO of Chilton Medical Center and became a health system executive with Atlantic Health System in New Jersey, after system integration. Disclosure: Deborah Zastocki, DNP, EdM, MA, RN, NEA-BC, FACHE(r) has no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.Writer: Cathryn Ayers, RN
Cathryn Ayers, RN, MSN has nearly 10 years of critical care experience. She was active in multiple committees to improve patient safety, executed staff education activities, and managed the new graduate orientation program for those entering intensive care units. Cathryn obtained a license for massage and bodywork therapy in 2012 and graduated from the University of North Carolina at Greensboro in 2016 with a Master of Science in Nursing Education. She has provided telephonic case management services and developed program materials to facilitate positive outcomes for people with rare conditions across the United States. Cathryn has a passion for teaching and helping others to be their best. Disclosure: Cathryn Ayers, RN has no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.
The target audience for this course is: Nurses; Pharmacists; Physicians; in the following settings: Acute Care Facility.
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support here.
