Revenue Chapter 10 CYU

  1. What 3 components do value based purchasing (VBP) systems & pay for performance (P4P) systems typically link?
    Quality, performance, payment
  2. What 3 reports provided the impetus for VBP/ P4P systems?
    To Err Is Human, Crossing The Quality Chasm & Rewarding Provider Performance
  3. T or F VBP/ P4P systems only include financial rewards.
  4. T or F VBP/ P4P systems have been slow in getting established since 2004.
  5. What are the 2 major categories of VBP/ P4P models.
    Reward based & penalty based
  6. What targets should be the focus of VBP/ P4P systems?
    Most significant problems in terms of quality or cost, Proportion of population covered by the service or provider, Availability of valid & reliable performance measures
  7. What is the ramification for hospitals that do not participate in, or do not submit sufficient data under the Hospital IQR program?
    A 2% reduction of payment penalty for a year
  8. How did the hospital penalty changed under the revised Hospital Acquired Conditions Reduction Program?
    It moved from a per encounter reduction to an all encounter reduction
  9. Which focus area and conditions are included in the Hospital Readmissions Reduction Program?
    2015--Acute Myocardial Infarction, Heart Failure & Pneumonia. 2016--COPD & Total Hip & Total Knee Arthroplasty were added. 2017--CABG surgery was added.
  10. What 4 domains are included in the Hospital Value Based Purchasing Program?
    Clinical care, safety, efficiency and cost reduction, patient experience of care.
  11. How does the Physician Feedback Program/Value Based Payment Modifier support the move to reimbursing physicians for quality rather than quantity?
    The physician's data is reviewed and shared placing emphasis on quality instead of quantity. The Value Modifier is then applied to adjust the reimbursement based on the provider's quality & efficiency of care.
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Revenue Chapter 10 CYU