Title -Provider Evaluation (Quality & Safety)
In this age of acute competition and alignment of providers, systems are evolving to improve contracting opportunities, including population health, accountable care organizations, and models of health care delivery. They are targeting quality care at a value price. This assignment explores a provider of your choice to determine their desirability to be a member of a system and recommend improvements they may need to make to become more competitive in their market.
Write a two to three (2-3) page proposal in which you evaluate and make recommendations for a provider you have chosen in terms of safety, quality, and evidence-informed health care by doing the following:
1. Choose a health care provider — nursing home, hospital, home care, etc.
2. Using the search function at one of the medicare.gov sites (https://www.medicare.gov/hospitalcompare/search.html or https://www.medicare.gov/nursinghomecompare/search.html), review your provider’s measures on safety, quality, and evidence-informed health care. Pay attention to the publicly reported outcomes on mortality, rehospitalization, and infection rates, as well as patient satisfaction and preventive care.
Note: If you have chosen a home health provider, you can use the following website to review their home health quality measures https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Home-Health-Quality-Measures.html.
3. Identify other providers in the same geographic area, review their outcomes, and compare your provider (e.g. search by zip code).
4. Determine how these outcomes impact this provider as a potential member for a health system, accountable care organization, or as a contender to obtain population health contracts.
5. Based on the reports, determine which quality initiative the providers should address through evidence-based practices, such as safety, quality, rehospitalizations, mortality, etc.
6. Would your provider be a desired member of a system?
7. What is your recommendation for this provider to improve their outcomes in order to improve reimbursement and to become a desirable member of a system of providers?