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Flashcards in Payment for Outcomes Deck (20)
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1

Outcome

Degree of health or recovery

2

What is the gold standard in relation to PT outcomes?

Functional status

3

What other categories are in PT outcomes?

Pain level
Ability to return to physical activities
Ability to return to work

4

Value=

outcome/total cost

5

Pay for reporting

portion of data must be reported or payment is at risk

6

Pay for performance

part of payment is tied to performance

7

IMPACT ACT of 2014

SNFs, IRFs, and LTCHs must begin reporting on quality measures

8

Data set ffrom Impact must include:

Functional status and changes in function
Skin integrity and changes in skin integrity
Medication reconciliation
Incidence of major falls
Patient preferences

9

IMPACT ACT GOAL

To advance PAC (post-acute care) reform
Payment should be based on patient needs, not site of service

10

What did Post Acute Care sites (PACs) have to report on:

Medicare Spending Per Beneficiary (MSPB)
Discharge to community
Hospitalization rates of potentially preventable readmissions

11

Global Function

Measures that quantify patient’s overall functional status
Includes mobility, ADLs, etc. (e.g., OPTIMAL, AMPAC, PROMIS, SF-36

12

Condition/Body Region Specific

Measures that quantify functional status for a specific condition or body region
Activities for a condition or body region (e.g., Neck Disability Index, Oswestry, DASH, etc.)

13

Performance Based

Measures that quantify function specific to a task or tasks
Specific activities patient is asked to perform (e.g., Tinetti, TUG, 6-Minute Walk Test, etc.)

14

Quality assessment

refers to measurement of quality compared to some goal or standard

15

Quality assurance

continuous quality improvement

16

5 things that most affect customer satisfaction

Communication of treatment plan from patient’s perspective
Consistency of clinicians
Respect for patient autonomy & patient input
Time clinician spends with patient
Clinician understands patient’s history & condition

17

4 steps of CQI:

Measure performance: where are we now?
Set goal for future performance: where do we want to be?
Implement process changes: how do we get there from here?
Measure: were we successful in getting there?

18

Comparative effectiveness research

Comparison of one form of treatment versus another

19

Who does G codes apply to?

All practice settings that provide outpatient PT, OT, and SLP services for Medicare Part B beneficiaries

20

Functional limitation categories

Mobility
Changing and maintaining body position
Carrying, moving and handling objects
Self care
Other