Hennepin Healthcare, Minnesota: Value-Based Purchasing (VBP)

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  1. Discuss To What Degree Your Organisation Has Embraced VBP
  2. Ethical Clinical and Ethical Business Practices
  3. Timeline
  4. Executive Summary
  5. References

Various healthcare trends have compelled the United States to develop innovative strategies that will help provide effective care for less cost. With such improvement, healthcare providers have a duty to demonstrate that they are offering high-quality care at an affordable cost. Most healthcare facilities have adopted value-based purchasing (VBP) to move their organizations from the world of fee-for-service (FFS). The adoption of VBP in hospital environments has helped to eradicate medical errors which were previously rampant. The implementation of VBP is a comprehensive process which requires contributions from relevant stakeholder and department within healthcare settings.

Discuss To What Degree Your Organisation Has Embraced VBP

Value-based purchasing (VBP) refers to a program meant to incentivize certified Medicare home health agencies and ensure that they provide better patient care outcomes at lower costs. Such an achievement is made by moving healthcare agencies away from the traditional fee-for-service model to an outcome-based model (Cattel & Eijkenaar, 2019). By implication, provider payments are linked to foster the improvement of the performance of healthcare providers.

VBP establishes a form of payment that holds healthcare providers accountable for both the costs of medication and the quality of care they provide. Arguably, through the creation of accountability, VBP plays a vital role in reducing medical errors and increasing organizational performance. It is observed that VBP often rewards medical organizations that perform best. The organization I work in is Hennepin Healthcare, Minnesota.

Hennepin Healthcare has implemented several initiatives towards the establishment of the ;VBP program. Such initiatives have been designed to reform payment and care delivery processes. However, there are additional three domains of VBP recommended for implementation in the current strategic plan to ensure that Hennepin healthcare becomes the best facility in the Minnesota region. First of all, Hennepin healthcare will create Patient-Centered Medical Homes (PCMH), which refers to a care model that allows patients to receive treatment coordinated by their primary care physician (Cattel & Eijkenaar, 2019).

Such an organized care plan ensures that patients receive the necessary care where and when they need it, and in a manner that they can understand best. The main objective driving the recommendation to establish PCMH is to create a centralized setting, facilitating a partnership between patients, physicians, and family members. PCMH model of care will ensure that Hennepin healthcare consistently undertakes registries through information technology and allows for effective communication and medical care information exchange. In other words, PCMH will ensure that patients receive comprehensive care since it focuses on a patient-centered approach, allows for coordinated care, facilitates access to services, and ensures quality and safety.

The second initiative that will be implemented is enrolment to the Accountable Care Organizations (ACOs). These refer to groups of care providers, physicians, and hospitals that agree to work together and provide coordinated care services to patients (Rosen et al., 2018). Besides, ACO participants often agree on how to take responsibility regarding the total medical care costs for their patients. It is noted that the Center for Medicare and Medicaid Services ended the Hospital and service care quality compare websites, leading to a merger and consequential formulation of a single website known as Care Compare. This strategy is recommended for implementation in Hennepin healthcare to build upon the VBP since the organization provides care to people with Medicare.

The third initiative recommended for implementation is the establishment of delivery system reform incentive payment (DSRIP). This will be the leading initiative through which Hennepin healthcare will implement the Medicaid Redesign Team (MRT) Waiver Amendment. DSRIP in the Hennepin healthcare facility’s context will lead to a change in the structure and incentives, thus encouraging quality, efficiency, and coordination of reward care (Rosen et al., 2018). Concerning Medicaid managed care plans, Hennepin healthcare should implement VBP models of payment such as bundled and episode-based payments, which meet the CMS criteria. Arguably, Hennepin healthcare has embraced VBP to a substantial degree, and implementing these three VBP domains will substantially improve the facility’s quality of services.

Department One (Organization Management team)

The organization’s management team plays a vital role in the development and implementation of any organizational programs. Its primary functions include preparing and advancing corporate work plans, equitable distribution of organization resources, and setting standards to ensure that clients receive quality services (Salas, Zajac & Marlow, 2018). Furthermore, the management team maintains proper records of data and information and ensures proper management of finances, supplies and commodities, equipment, and infrastructure (Rosen et al., 2018). The management team also provides preparedness and timely response to emergencies and carries out development and human resource management. Given these roles, the management team is the primary player in the process of implementing VBP.

For instance, the chief financial officer influences the implementation of VBP by formulating organizational strategies together with the management team. The officer articulates economic models used by the organization, creates and manages budget reports, supervises financial operations, and ensures there is a good investor relationship. The hospital technology team works alongside the management team to establish the Key Performance indicators (KPIs), which help organizations maximize their reimbursements (Salas et al., 2018). The human resource department in the management team works together with the finance manager to ensure that Hospital has enough staff, which meets the required low patient to caregiver ratio (Rosen et al., 2018). Once adequate staffing has been established, the management team works with the human resource department to evaluate the competency of the staff and ensure the staff gives quality care services. In other words, the management team creates a favorable environment for improving staff productivity.

Department Two(The nursing department)

The nursing department is directly involved in the process of improving the quality of care services. It is observed that nurses coordinate communication between caregivers such as physicians and patients. Besides, nurses play vital roles in developing organizational culture geared towards the appreciation of high-quality performances. By implication, nurses often integrate their practices into organizational goals and ensure excellence in patient outcomes (Rosen et al., 2018).

Nurses will achieve such outcomes by effectively enhancing and communicating strategic goals to all the staff levels. Besides, nursing leaders are responsible for identifying the nursing-sensitive indicators (NSIs) that need to be improved. Evidently, by identifying various NSIs, the nursing department effectively gives recommendations that would be included in the VBP to ensure that patients receive the best care services at affordable costs at the end (Park & Choi, 2017).

Nonetheless, the nursing department also provides direct nursing care to patients (Rosen et al., 2018). Thus, they understand best the protocols and standards of care. Such an understanding is a prerequisite in implementing organizational initiatives such as the VBP since nurses will effectively recommend the innovative changes required in making health policies. Besides, the nursing department is responsible for monitoring health policy regulations, thus ensuring they are supportive to both nursing practice and patient care. Evidently, the implementation of VBP is enhanced through effective collaboration between the nursing and the management departments (Park & Choi, 2017). The VBP standards ensure that patients receive the best quality care at low costs and that hospitals form joint operation strategies that can be implemented better by nurses.

Department Three(The records and information technology department)

This department serves to record all the information related to patients and manage such information so that it can benefit the management, service providers, and patients. Through the use of information technology, medical records are availed electronically (Gardner et al., 2019). Trained personnel in the IT department can effectively use the electronic medical record system (EMR) to record notes and information collected by a clinician. Such information is used by other care providers such as clinicians, physicians, and doctors to establish the most appropriate diagnosis and treatment measures to be used for a patient. The use of EMR improves the quality of care in many ways. First, it improves the communication process in the entire medical care process and supports decision making regarding diagnosis and treatment (Gardner et al., 2019).

Secondly, EMR improves adherence to guideline-based care, leading to a reduction in medication error rates. The information technology department thus impacts the implementation of VBP by ensuring that there is the easy accessibility of all the relevant patient information, which is required in improving the quality of care, maintaining patient safety, and establishing service efficiency (Gardner et al., 2019).

Such elaborate information allows for effective development and incorporation of favorable health policies in the VBP, eventually achieving high-quality care services at low costs. The information technology department can also provide budgets, which can be used to evaluate the monetary costs of implementing VBP. When the records and information technology work together with the financial department, it becomes easier to establish the best costs of care services to be offered after implementing the VBP (Gardner et al., 2019). In other words, the records and information technology department help the management in making informed decisions by providing human resource information systems (HRIS), clinical information system (CIS), decision support system (DSS), and electronic medical records (EMRs).
  • The organization management team‘s goal- The management team will set standards meant to increase medical efficiency by 20% in 36 months by increasing healthcare partnerships.
  • The nursing department‘s goals are the improvement of nursing communication efficiency by 30% and reduction in medication errors by 15% within the next three years.
  • The records and information technology department‘s goal is to improve patient information recording, access, and clarity by 20% in the next three years, through the use of electronic medical record system.
Attaining Quality Outcomes inpatient care for the next three years

  • Reduction in the per capita healthcare costs.
  • Improvement in the health of populations.
  • Reduction in staff and clinician burnouts.
  • Improvement in the patient’s care experience.
  • Enhancement of partnership and collaborative care services.
  • Improvement in healthcare education, leading to better quality care.
 Quality Outcomes in reimbursement for the next three years

  • Increase in outpatient admissions.
  • Reduction in inpatient admissions.
  • Reduction inpatient readmissions due to quality outcomes.
  • Improvement in HCAHPS due to higher patient satisfaction.
  • Key Points for the organization management team- healthcare partnerships, medical service efficiency, and better healthcare management skills.
  • Key points for the nursing department- nursing communication efficiency, patient and family education.
  • Key points for records and information technology department-improved use of EMRs, reduction in medical errors due to limited misrepresentations, and collaborative performance.
Marketing Key points:

  • Marketing Key points for organization management team-
    • Healthcare partnerships- marketing partnerships involves how organizations communicate critical information to partners. The management department shall form proper communication channels such as mails and also organize frequent and necessary meetings with the partners.
    • Medical service efficiency- the management will ensure through frequent staff meetings that all the staff are efficient and effective in their duties.
    • Better healthcare management skills-the management department apart from hiring competent staff will offer constant training to staff.
  • Marketing Key points nursing department:
    • nursing communication efficiency- to be marketed through establishment of proper communication channels.
    • Patient and family education-by offering workshops.
  • Marketing Key points for records and information technology department:
    • Improved use of EMRs-by increasing the number of electronic resources.
    • Reduction in medical errors due to limited misrepresentations-by ensuring constant updates in the databases.
    • Collaborative performance-by ensuring all records internal intranet is operational.
Coordinating Informational Events:

  • The management department articulates clearly the expectation to give patients the best quality care.
  • The human resource department evaluates the number of care providers that will ensure the ratio of a caregiver to care, the recipient is lowered
  • The financial department gives all the budgeting and financial capacity of the organization.
  • The records and information technology department helps the management in making informed decisions by providing human resource information systems (HRIS), clinical information systems (CIS), decision support systems (DSS), and electronic medical records (EMRs).
  • The nursing department give information regarding the nursing-sensitive indicators that need to be improved.
  • The management department communicates on all the implementation plan requirements and lays down policies to be observed during and after implementation
 Coordinating Educational Events:

  • The management department creates opportunities for employee development and growth.
  • The nursing department, after improving their knowledge, educates patients and families on medical issues and processes.
  • The human resource department evaluates staff performance and educates the staff on how to increase performance efficiency.
  • The financial department advises the management, human resource department, and IT department on financial issues and the cost related outcomes.

Ethical Clinical and Ethical Business Practices

The strategic plan discussed herein will incorporate both ethical business and ethical clinical practices. The ethical clinical practices will help in will provide a multidisciplinary lens to view complex issues and draft recommendations related to the appropriate course of action to be undertaken. There are several ethical clinical practices incorporated in the current strategic plan (Sroka & Szántó, 2018).

The first practice is nonmaleficence, which requires that no harm be inflicted on patients, so beneficial outcomes came to be realized. In the current plan, while implementing the VBP, all the harms and possible effects are considered part of the ethical decision-making process. Both long term and short-term harms, though unintentional, are noted and incorporated in the strategic plan such that the resultant VBP services can produce the best patient outcome with the least amount of harm (Sroka & Szántó, 2018).

The second ethical clinical practice will be autonomy, which requires that the rights, beliefs, and opinions of patients be respected in the process of making decisions. While outlining the strategic plan of implementing the VBP, the management department, nursing department and the information technology department will be educated on the need to respect patients’ views. They are made to understand that it is vital to provide patients and their family members relevant information regarding the medication process before conducting any medication process (Sroka & Szántó, 2018). The third ethical practice incorporated in the strategic plan is justice, which will ensure that care providers are fair and that they handle similar cases in identical ways without bias or discrimination.

One of the ethical business practices used in the development of the current strategic plan is honesty. All the team members are educated on the need to remain truthful in all their dealings. Additionally, they are reminded not to mislead others through practices such as misrepresentation, selective omissions, overstatements, or any other way (Chaet et al., 2017). The second practice concerns others, where policies ensure service providers show care, kindness, compassion, and benevolence to patients and team members. In other words, this practice will ensure that care providers can help people in need and accomplish their business objectives in a way that causes the least harm and the most significant possible medical outcomes (Chee et al., 2016).

Accountability is the third ethical practice used. It ensures that care providers acknowledge and accept individual accountability regarding the ethical quality of decisions they make. Besides, this practice is vital in ensuring that care providers take responsibility for omissions and errors they make (Chaet et al., 2017). As such, the resultant VBP purpose of lowering service costs and providing the best care outcomes will be established because care providers will be keener.

Timeline

Time Increments Organization Management Team Nursing Department Information Technology Department
First Year
  • By the end of the first year, the management team will be provided with evidence-based information to help in establishing proper planning, controlling, and evaluation of the VBP.

Events to aid information

  • Management meetings to inform staff about new objectives
  • All the improved HCAHPS observed to create satisfaction will be displayed on the homepage and compared to national and state averages.

Events to aid Education

  • Educative materials outlined in HCAHPS, and elaboration on their impacts on reimbursement
  • Staff training and appraisals
  • By the end of the first year, this department will be given all the information guiding evidence-based practice to help them in constructing a plan that can improve communication.

Events to aid information

  • Regular staff meetings will be conducted to inform the staff of any new changes.
  • All the improved HCAHPS observed to create satisfaction will be displayed on the homepage and compared to national and state averages.

Events to aid Education

  • Individualized training outlining how to conduct bedside reporting
  • Use of educative materials outlines in HCAHPS, and elaboration on how they impact reimbursement.
  • By the end of the first year, the IT department will be provided with all the information regarding evidence-based practice use of EMRs.

Events to aid information

  • Regular staff meetings will be conducted to inform the staff of any new changes.
  • All the improved HCAHPS observed to create satisfaction will be displayed on the homepage and compared to national and state averages.

Events to aid Education

  • Individualized training outlining how to record patient information using EMRs
  • Use of educative materials outlines in HCAHPS, and elaboration on how they impact reimbursement.
Second Year
  • By the end of year 2, the newly developed strategic plan for increasing the management functions of planning, controlling, and evaluating VBP will have passed its preliminary stage and implemented in the entire Hospital.

Events to aid information

  • Enhancement of quarterly report updates regarding any new changes
  • Facilitate extra real-time staff training by implementing more champions

Events to aid Education

  • Conduct more individualized training on how to use the implemented management plan
  • Provide managers with time to attend more lessons about management functions and skills
  • By the end of the second year, the drafted plan on improving nursing communication will have completed its experimental or preliminary trial, and its implementation is done in the entire Hospital.

Events to aid information

  • Enhancement of quarterly report updates regarding any new changes
  • Facilitate extra real-time staff training by implementing more champions

Events to aid Education

  • Conduct more individualized training on how to use the implemented communication plan
  • Hold more education functions to expound on the benefits of improved communication.
  • By the end of the second year, the new strategic plan on effectively using EMRs in recording patients’ information will have completed its preliminary trial, and its implementation is done in the entire Hospital.

Events to aid information

  • Enhancement of quarterly report updates regarding any new changes
  • Facilitate extra real-time staff training by implementing more champions

Events to aid Education

  • Conduct more individualized training on how to use the implemented EMRs improvement plan
  • Hold more education functions to expound on the benefits of improved EMR use.
Third Year
  • By the end of the third year, the implemented strategic plan on how management can increase the efficiency of its functions of planning, controlling, and leading the VBP implementation will be evaluated.

Events to aid evaluation

  • Engagement of all the stakeholders
  • A clear description of the purpose of the implemented management functions improvement plan

Events to indicate the effectiveness

  • Increase in medical efficiency by 20% or more
  • Increase in healthcare partnerships and healthcare quality outcomes, and reduction in medical costs
  • By the end of the third year, the implemented strategic plan on how to improve nursing communication efficiency will be evaluated.

Events to aid evaluation

  • Engagement of all the stakeholders
  • A clear description of the purpose of the implemented nursing communication improvement plan

Events to indicate the effectiveness

  • Improvement of nursing communication by 30% or more
  • Reduction in medication errors by 15% or more, and increase in quality care outcomes and patient satisfaction
  • By the end of the third year, the implemented strategic plan on how improve the efficiency of IT department in using EMRs will be evaluated.

Events to aid evaluation

  • Engagement of all the stakeholders
  • A clear description of the purpose of the implemented EMRs improvement plan

Events to indicate the effectiveness

  • Improvement of patient information recording, access, and clarity by 20% or more
  • Reduction in medication errors by 15% or more, and increase in quality care outcomes and patient satisfaction

Executive Summary

Hennepin Healthcare, Minnesota: Value-Based Purchasing (VBP)

Components of VBP Most Pertinent to the Organization

The primary components of VBP that are pertinent with the organization include safety, improved clinical care, improved efficiency and costs reduction, and enhancement of patient and caregiver centered experience. VBP improves efficiency and reduces medical costs by reducing Medicare spending per beneficiary. In other words, VBP will help in incentivizing the organization and improving value and quality of care.

Preparation Needed by the Three Departments for Implementation of VBP in the Next Three Years

For effective implementation of VBP in the next three years, each of the three departments will have to prepare adequately, in different ways.

Organization Management Team

The organization management team plays vital roles in formulating strategies that ensure the whole VBP implementation process is successful. Some of the ways through which this department will prepare for implementation of VBP in the next three years include:

  • Creation and management of budget reports, with the help of chief financial officer
  • Establishment of strategies to ensure effective supervision of financial operations
  • Predetermination of the service workforce needed in the implementation of VBP and establishment of appropriate salaries by the HR management.
  • Formulation of relevant strategies to aid in ensuring preparedness, and timely responses to emergencies that will arise in the course of implementing VBP.
The Records and Information Technology Department

The preparations required by this department include:

  • Effective training of IT personnel to ensure that all the information related to patients is recorded and managed, so that it can benefit the management, service providers, and patients across the three years
  • Develop strategies that will facilitate easy accessibility of patient information
  • Establish strategies that will ensure that IT department works in collaboration with the financial department. Such preparation is necessary because it facilitates determination of the best costs of care services to be offered after implementing the VBP.
  • Teach all its members on how to use EMRs, which will improve the communication process in the entire medical care process and support decision making regarding diagnosis and treatment. Thus, smooth implementation of VBP across the three years.
Nursing Department

In preparation, the nursing department will:

  • Establish better strategies of identifying nursing sensitive indicators, then communicating the findings to management department for incorporation in the implemented VBPs.
  • In addition, this department will focus on how to provide high quality direct care to patients, for easy identification of more nursing sensitive indicators.
  • Nursing department will also formulate strategies on how to coordinate communication between caregivers such as physicians and patients in the course of implementing VBPs.

Necessary Education and Training

To fully implement VBP in the facility, education and training will be offered to all the personnel in all three departments, this education will be in yearly phases. The first phase in all the departments’ will involve awareness creation concerning VBP. Then the second phase will be for planning, controlling, and evaluating information about VBP. The third phase will be implementing the VBP plan to ensure all the departments achieve core goals of VBP.

References

Cattel, D., & Eijkenaar, F. (2019). . Medical Care Research and Review, 77(6), 511-537. Web.

Chaet, D., Clearfield, R., Sabin, J. E., & Skimming, K. (2017). . Journal of General Internal Medicine, 32(10), 1136-1140. Web.

Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). . Circulation, 133(22), 2197-2205. Web.

Gardner, R. L., Cooper, E., Haskell, J., Harris, D. A., Poplau, S., Kroth, P. J., & Linzer, M. (2019). . Journal of the American Medical Informatics Association, 26(2), 106-114. Web.

Park, M. J., & Choi, D. W. (2017). The convergence effect of career education program for freshmen of nursing department on learning motivation, college life adaptation and self-efficacy. Journal of Digital Convergence, 15(4), 339-349. Web.

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433-450. Web.

Salas, E., Zajac, S., & Marlow, S. L. (2018). . Group & Organization Management, 43(3), 357-381. Web.

Sroka, W., & Szántó, R. (2018). Corporate social responsibility and business ethics in controversial sectors: Analysis of research results. Journal of Entrepreneurship, Management and Innovation, 14(3), 111-126.

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