Funding At Risk for Outcomes and Quality Improvement Sample Clauses

Funding At Risk for Outcomes and Quality Improvement. The percentage of DSTI funding at risk for improved performance on validated outcome or quality measures will gradually increase from 0 percent in SFY 2015 to 10 percent in SFY 2016 to 20 percent in SFY 2017 (averaging to 10 percent total over the three year period). This accountability structure is on a provider-specific basis. In addition, CMS will retain the existing “pass/fail” funding accountability for metrics associated with project activities (structural and process). Outcome measures focus on assessing progress on health outcomes that result from the structural and process modifications or improvements. Examples include impacts on morbidity, mortality, or readmissions. The specific outcome and quality measures will be defined in the approved Master DSTI Plan and hospital-specific plans described in STC 52. Examples of approvable metrics for outcome measures include but are not limited to: Agency for Healthcare Research and Quality (AHRQ) inpatient quality indicators and pediatric quality indicators National Quality Forum CMS Adult or Child Core Measures CMS Inpatient Quality Reporting (CMS-IQR)/Joint Commission The U.S. Preventive Services Task Force (USPSTF) Preventive Measures AHRQ Preventive Quality Indicators National Quality Forum (NQF) 0028 – Preventive Care and Screening NQF 0712 - Screening for clinical depression Transition of Care Measure CTM-3 NQF 0554: Medication Reconciliation Post-Discharge (MRP) NQF 0441 – Assessed for rehabilitation NQF 1604 – Total Cost of Care Population Based PMPM Index Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) National Committee for Quality Assurance (NCQA) Massachusetts Patient-Centered Medical Home Initiative Measures Aggregate DSTI Outcome and Quality Improvement Accountability. Overall DSTI project funding is available up to the amounts specified in the special terms and conditions and Attachment E. As a general matter, DSTI funding is subject to the provider meeting the specific metric in the approved Master DSTI Plan. In addition, pool wide achievement of performance goals and targets must be achieved or maintained for full access to the funding level specified in the STCs, Attachment E and the DSTI Master Plan. Performance goals and targets for the DSTI providers will be defined in the Master DSTI Plan. The performance goals and targets will be based on the four domains described above. In DY 20 (SFY 2017) (the third year of the renewal period), the DSTI hospitals must sho...
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Funding At Risk for Outcomes and Quality Improvement. The percentage of DSTI funding at risk for improved performance on validated outcome or quality indicators in Categories 4A and 4B will gradually increase from 0 percent in SFY 2015 to 10 percent in SFY 2016 to 20 percent in SFY 2017 (averaging to 10 percent total over the three-year period). This accountability structure is on a provider-specific basis. Overall DSTI project funding is available up to the amounts specified in the special terms and conditions and Attachment E. As a general matter, DSTI funding is subject to the provider meeting the specific metric in the approved Master DSTI Plan. In addition, pool wide achievement of performance goals and targets must be achieved or maintained for full access in DY 20 (SFY 2017) to the funding level specified in the STCs, Attachment E and the DSTI Master Plan. In DY 20 (SFY 2017) (the third year of the renewal period), the DSTI hospitals must show improvement relative to DY 18 (SFY 2015) performance baselines. If the DSTI providers do not meet the required aggregate performance goals as specified by the DSTI Master Plan by the end of year three, the DSTI pool will be subject to a five percent reduction in available funding. In other words, if the DSTI hospitals do not demonstrate the aggregate performance improvements as specified in the DSTI Master Plan, five percent of the DY 20 DSTI funding will be withheld. This reduction, if applicable, will be taken at the end of the three-year period. The five percent reduction is an aggregate pool wide penalty based on three years of performance. It is not an additional penalty imposed on an individual provider for not meeting a specific metric. CMS will work with the Commonwealth to assure that any reduction penalty is equitable. The aggregate pool wide penalty will take effect if the DSTI hospitals do not meet two criteria by the end of DY20. Safety Net Hospital performance on delivery system at-risk Category 4A measures. The set of at-risk measures in Category 4A of Attachment J implemented by hospitals will be assigned a direction for improving or worsening and will be calculated to reflect the performance of all of the safety net hospitals. This milestone will be considered passed in DY20 if more of the at-risk measures in Category 4A for DY19 (SFY 2016) and DY20 (SFY 2017) are improving for all safety net hospitals than are worsening (i.e. the performance level is the same or better, no error bar applied), as compared to initial hospital performance baseline ...
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Funding At Risk for Outcomes and Quality Improvement. The percentage of DSTI funding at risk for improved performance on validated outcome or quality measures will gradually increase from 0 percent in SFY 2015 to 10 percent in SFY 2016 to 20 percent in SFY 2017 (averaging to 10 percent total over the three year period). This accountability structure is on a provider-specific basis. In addition, CMS will retain the existing “pass/fail” funding accountability for metrics associated with project activities (structural and process). Outcome measures focus on assessing progress on health outcomes that result from the structural and process modifications or improvements. Examples include impacts on morbidity, mortality, or readmissions. The specific outcome and quality measures will be defined in the approved Master DSTI Plan and hospital-specific plans described in STC 52. Examples of approvable metrics for outcome measures include but are not limited to: i. Agency for Healthcare Research and Quality (AHRQ) inpatient quality indicators and pediatric quality indicators ii. National Quality Forum iii. CMS Adult or Child Core Measures iv. CMS Inpatient Quality Reporting (CMS-IQR)/Joint Commission v. The U.S. Preventive Services Task Force (USPSTF) Preventive Measures vi. AHRQ Preventive Quality Indicators vii. National Quality Forum (NQF) 0028 – Preventive Care and Screening viii. NQF 0712 - Screening for clinical depression ix. Transition of Care Measure CTM-3 x. NQF 0554: Medication Reconciliation Post-Discharge (MRP)
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