Clinical

Everyone has points in their career that they recall with great clarity. One of those moments for me was in the fall of 2013 with the addition of the Medicare Spend per Beneficiary (MSPB) measure. As a nurse and quality professional, MSPB was like a golden thread that brings everything together: quality, safety, patient experience, inpatient and outpatient care, provider revenue and payer spend. Care delivery was finally becoming connected in a way that had the potential to engage everyone... More

As a certified data junkie, I have spent a considerable amount of time studying the composition of the CMS Overall Hospital Quality Star Rating program. While I understand and appreciate what CMS is trying to provide patients and the public at large, I am not a fan of the current methodology, which I feel doesn’t result in an accurate reflection of the quality of care hospitals are delivering across our country. More

In health care, clinicians have been trained that using safety checklists, watching for changes in vital signs and reviewing fluctuations in labs can catch a problem early or, even better, avoid it completely by taking a proactive approach. Success at these tasks is often rewarded with promotion to front-line leadership roles. However, many aren’t prepared to take on responsibility for planning, forecasting, coordinating and leading as many as 100 employees and maintaining high levels of... More

The U.S. is in the midst of a national crisis. In the past two decades we have seen increasing use, abuse and deaths associated with opioid medications. Here are a few disconcerting trends*: Prescribing opioids is on the increase. Approximately 20% of patients receive an opioid prescription for non-cancer-related symptoms or pain-related diagnosis in America. This 20% translates to approximately 259 million prescriptions or an equivalent of one bottle of opioids for every adult in America. More

An alphabet soup of regulations, guidelines and standards, all competing for resources, some financial and almost all involving human capital to implement and execute, are coming at clinicians and hospital administrators faster than the F-18s that fly over my neighborhood in Virginia Beach. The speed and pace of change in our industry have managers’ and staffs’ heads spinning. The first challenge is staying on top of the information that is coming fast and furious while also... More

Health care spending in the U.S. exceeds $3 trillion per year and 10% of the population – the chronically ill – accounts for approximately 60% of that cost. Those patients are distinguished by their complex medical conditions that often require costly interventions. As noted in a previous Vizient blog, more than two-thirds of Medicare beneficiaries have multiple chronic diseases and a staggering 93% of total Medicare spending goes toward beneficiaries with multiple chronic... More

In 1989, the National Weather Service retired its coastal warning display system in favor of electronic communication and other technological advances. For more than 100 years prior, colored pennants, flags and lights were used to warn mariners of impending storms. In the 19th century, those warnings often came as the result of sailors having beaten a path to port ahead of storms they had seen with their own eyes. More

It is no secret that CMS intends to keep pushing the health care industry toward value-based reimbursement through its evolving payment models. The proposed rule for the Medicare Access and CHIP Reauthorization Act (MACRA) offers a new method of paying clinicians for the value of care they provide. It proposes implementing this change through a framework consisting of two paths: the Merit-based Incentive Payment System (MIPS) or advanced Alternative Payment Models (aAPMs). More

A recent article in Modern Healthcare reported on the enthusiasm over outpatient joint replacement surgery for younger and healthier patients. The arguments in favor of the shift for a subset of carefully selected patients are compelling. Quicker recoveries, faster return to normal activities, and reduced exposure to infections and other risks associated with hospitalization make a strong case for the change of venue. More