QAPI Program Utilization_Manual

- Management following fracture - Pharmacologic therapy - Counseling for Vitamin D, calcium intake and exercise • Screening for fall risk • Medication reconciliation • Urinary Incontinence in women 65 years older - Assessment of presence or absence of - Characterization of - Plan of care • Electrocardiogram for syncope • For community-acquired pneumonia - Assessment of oxygen saturation - Assessment of vital signs - Assessment of mental status CMS Medicaid/SCHIP Quality Strategy includes the following: • Evidence-based Care and Quality Measurement • Payment Aligned with quality • Health Information Technology • Partnerships • Information Dissemination, technical Assistance, and sharing of best practices • Evidence-Based Care and Quality Measurement CMS support states in their efforts to improve performance measurement and ultimately the quality of care thought the use of evidence-based measure sets that have wide acceptability in the healthcare industry. • Payment Aligned with Quality Quality-based purchasing, also known as pay-for-performance (P4P) , is a quality improvement and reimbursement methodology which is aimed at moving towards payments that create much stronger financial support for patient focused, high value care. Pay-for-performance attempts to promote reimbursement for quality, access efficiency, and successful outcomes, CMS supports states in their efforts to implement P4P programs. » Staying Abreast of Changes in Healthcare Staying abreast of trends that affect the home health industry gives agency executives better insight to determine future business strategy, sales and marketing plans, care provision, outcomes management, and technology needs. Most prominent are (in no particular order): • CMS Quality Initiatives/P4P across all healthcare settings • Medicare’s initiatives for Value Based Purchasing of Healthcare • CMS focus on prevention and wellness-focus on vaccinations, seniors with multiple chronic conditions • Obesity-has doubled in the Medicare population since ‘87, medical spending to treat Medicare beneficiaries has almost tripled. • Shift to consumer-driven healthcare-Consumers are being given provider outcomes, health information and more responsibility for their own healthcare decisions. • Continued rise in number of uninsured • Well-educated, discriminating and demanding baby boomers • Hospital-At-Home Care • Electronic Health record and Web-based technology 99