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Value Based Purchasing – How It Will Change the Status Quo
Why Case Management Is the Constant in Healthcare Change
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Wednesday, July 27, 2011
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Change is the new constant in today’s healthcare landscape. Regulatory changes, reductions in payment for readmissions, documentation changes to demonstrate accountability, incentives linked to the patient experiences are just a few of the changes that providers are preparing for as the country plans to implement value-driven healthcare.
The one constant is that case managers continue to be in the unique position to assist hospitals and other providers in rising to the challenges that will change the current healthcare landscape as we know it.
With mandated goals of cost containment and improved outcomes coming from employers, the state and federal governments and commercial payers, case managers are being looked at to strategically manage services for patients across the care continuum. Today's case managers need to be able to consider clinical, financial, and patient advocacy functions simultaneously, as they balance competing interests.
Gather your team to participate in the July 27, 2011, Case In Point Webinar, Case Management: The Constant in Health Care Change: How Value Based Purchasing will Change the Status Quo to learn how Value Based Purchasing will change the way each healthcare professional and patient participates in health and healthcare. Be an active participant in this important webinar. If you or your organization has questions, feel free to send them to Anne Llewellyn at allewellyn@accessintel.com by July 26. The faculty will address them during the Question and Answer period.
About the Webinar
As payers and providers throughout the healthcare industry prepare for the implementation of value-based purchasing, the Centers for Medicare and Medicaid has listed eight goals that prepare the way. Case management is tied to nearly every goal, illustrating the critical role case managers will play in the changing healthcare environment. The goals that CMS has laid out are:
- Financial Viability: where the financial viability of the traditional Medicare Fee for service program is protected for beneficiaries and taxpayers.
- Joint Accountability: where physicians and providers are linked to the value (quality and efficiency) of care provided.
- Effectiveness: where care is evidence-based and outcomes driven to better manage disease and prevent complications from them.
- Ensuring Access: where a restructured Medicare fee-for-service payment system provides equal access to high-quality, affordable care.
- Safety and Transparency: where a value-based payment system gives beneficiaries information on the quality, cost and safety of their healthcare.
- Smooth Transitions: where payment systems support well-coordinated care across different providers and care settings.
- Electronic Health Records: where value driven healthcare supports the use of information technology to give providers the ability to deliver high quality, efficient, well-coordinated care.
In a CMS paper titled Roadmap for Implementing Value Driven Healthcare in the Traditional Medicare Fee-for-Service Program, it is noted that the rationale behind the change to value-based purchasing and away from our current payment system is to improve the quality of care provided and contain escalating cost of care. This changes CMS from a passive payer of services to an active purchaser of higher quality affordable care. It will also move away from the current concept of paying providers solely based on volume of services and create appropriate incentives encouraging all healthcare providers to deliver higher quality care at lower costs.
With cost containment and improved outcomes seen as the best way to rein in the nation’s healthcare costs, providers and payers will need case managers to strategically manage services for all patients. Case managers will have to consider clinical, financial and patient advocacy functions simultaneously, as they balance competing interests.
Program Objectives
- Define value-based purchasing and its impact on providers.
- Identify changes that will take place to enable providers to meet regulatory requirements as value-based purchasing is implemented through the industry.
- Describe the role case managers will play in improving the patient experience and ensuring patients receive safe, quality evidence-based care throughout the care continuum.
- Discuss the competencies providers, payers and case managers will need to compete in this changing healthcare environment.
Our Webinar Will Answer These Questions
- Why is the Center for Medicare and Medicaid changing to a value-driven healthcare system?
- Will this change to a value-based purchasing system be limited to CMS or will other commercial payers be impacted?
- What will the impact of the change from value-based purchasing be to hospitals, skilled care facilities, home care agencies, physicians and organizations that provide care for patients with end stage renal disease?
- What changes in practice will be needed by case managers to meet the challenges of value-based purchasing throughout the care continuum?
- What competencies will be needed by case managers and other members of the healthcare team to move their organizations to be successful under this new business model of care?
- What resources are available to assist organizations in making the move to value based purchasing?
- What input will patients/families have as the industry moves to value-based purchasing on a national level?
- What measures will be used to evaluate hospitals and providers under this new delivery of care model?
- What system changes will providers and physicians need to be able to report outcomes and ensure transparency of their services required by the new reporting regulations?
- How will payers and providers work together to ensure safe, quality, evidence-based care for all consumers of healthcare?
Faculty
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Jean Moody-Williams, RN, MPP is the current Group Director for the CMS Quality Improvement Group (QIG). She has responsibility for the operation of the Quality Improvement Program and the End Stage Renal Disease Networks. Jean also leads many of the agency’s Value Based Purchasing programs in hospitals and End Stage Renal Disease facilities. |
Moderator: |
Patricia K. Scott, RN, MSNA, BSN, RHIA, CPMSM, CPHQ, is Vice President for Quality/Case/Risk Management and Regulatory Compliance with IASIS Healthcare Corporation. Patricia shares how IASIS Healthcare System is working by example to meet the changing dynamics in healthcare. In 2010, IASIS Healthcare was awarded two Healthcare Advantage Awards from Thomson Reuters for demonstrating success with improving quality and managing the cost of healthcare across the company’s 15 acute care hospitals. 
Joni Bokovoy, DrPH, RN is director of Healthcare Improvement and Research at Adventist Health corporate in Roseville, CA. In this role, she directs the clinical analytics team and works closely with clinical quality, information technology, accounting and other groups on Healthcare Knowledge Management as part of a larger Business Intelligence platform. She is actively involved in activities and projects designed to address Value Based Purchasing, Meaningful Use and Process Improvement She oversees a safety culture initiative begun in 2008, working with AH 17 hospitals and a world renowned safety researcher from Duke University to improve safety, teamwork and spiritual climate scores at all sites.
Who Should Attend
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Purchase Options
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- Live Webcast Registration – $329 (per-site fee)
- Webcast Recording on CD-ROM – $329
- Live Webcast and CD-ROM – $389
Continuing Education
Nurses: This program is approved for 1.5 contact hours for nurses by Commonwealth Educational Seminars (CES). As an APA approved provider, CES programs are accepted by the American Nurses Credentialing Center (ANCC). Every state Board of Nursing accepts ANCC approved programs except California and Iowa. However, CES is also an approved Continuing Education Provider by the California Board of Registered Nursing, (Provider Number CEP 15567) which is also accepted by the Iowa Board of Nursing
Certified Case Managers: This program is approved for 1.5 contact hours for case managers through the Commission for Case Manager Certification.
Disability Management Specialists: This program is approved for 1.5 contact hours through the Certification of Disability Management Specialists Commission.
Social Workers: This program is approved for 1.5 CE hours for Social Workers. Commonwealth Educational Seminars (CES) is approved as a provider for Social Work Continuing Education (ACE Provider #1117) by the Association of Social Work Boards (ASWB, 400 South Ridge Parkway, Ste B, Culpepper, VA 22701) www.aswb.org. ASWB Approval Period: 10/6/09-10/5/12.
Psychologists: Commonwealth Educational Services (CES) is approved by the American Psychological Association to sponsor continuing education for psychologists. Psychologists attending this program receive 6.5 CE hours credit. CES maintains responsibility for this program.
Licensed Mental Health Counselors/Certified Counselors: CES is recognized by the National Board for Certified Counselors to offer CE credit. (#5596). The program is approved for 6.5 CE hours credit. We adhere to NBCC Continuing Education Guidelines. The following state Counseling Boards accept programs offered by NBCC approved providers as part of license renewal: AL, AK, AR, DE, FL, GA, IL, IN, IA, ID, IL, KY, LA, ME, MA, MT, ND, NE, NH, NM, NC, NV, OK, OR, RI, SD, TN, TX, WA, and WV
Questions?
For questions regarding the Webinar or to register by phone, contact Hope Kabik at 301-354-1769.
If you are having any technical difficulties or need assistance meeting these requirements, please contact our Technical Support Center at 1-866-709-8255.
For content questions regarding this Webinar, contact Anne Llewellyn at 954-254-2950 or email allewellyn@dorlandhealth.com.
*Dorland Health does not offer any refunds for the webinar. All sales are final.
How Does the Webinar Work?
The live audio is delivered to your location over the telephone or your computer speakers. The Power-Point presentations are presented over the Internet and are available to print out before the program. This is like a talk-radio program with visuals on the Web. You and your team will be able to have a live Q&A with all the speakers.
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