Quality Improvement in Long-Term Services and Supports (QuILTSS)

Transcription

1 A Discussion with Consumers, Family Members and Interested Stakeholders: Quality Improvement in Long-Term Services and Supports (QuILTSS) This product was prepared with support provided through a grant from the Robert Wood Johnson Foundation s State Quality and Value Strategies program.

2 Thank You for Participating! Important moment for Tennessee s older adults and those who care for them Creating a new way of defining quality of care and rewarding professional caregivers for better quality performance Today is a chance hear your ideas-we value what you have to say Your thoughts will help us design the approach

3 QuILTSS Overview Like individual squares on a quilt, there are many ways to define quality Identify what is most important to people who receive LTSS and their families Develop new way to pay, so those performing better can earn higher payments

4 A Definition of Quality HealthCare: Doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results. The Agency for Healthcare Research and Quality (AHRQ), the federal government s leading agency charged with improving the quality, safety, efficiency and effectiveness of health care for all Americans

5 A Definition of Quality in LTSS: Providing the right care in the right place at the right time in the right way to achieve the best possible results that helps people live the lives they want to live

6 How is Quality Measured Today? Five-Star Quality System Help consumers, families, and caregivers compare nursing home quality 5-star rating is best Even if a facility earns 5, it does not earn any more money for their great work

7 How is Rating Determined? Nine Clinical and Physical Measures Quality Measures Health Inspections Surveys and Complaints Staffing Number of Staff to Resident, adjusted for resident needs

8 Tennessee s Current Performance The overall average Five-Star rating for Tennessee skilled nursing homes is 2.9. Our state ranks 48 out of 50. SkilledNursingFacilities.org

9 Many Efforts to Improve Quality Advancing Excellence in America s Nursing Homes Campaign A voluntary national program with 50% of Tennessee facilities participating Facility works on three goals each year with assistance to reach goals in nine key areas Efforts to improve dementia care Quality Assurance Performance Improvement (QAPI) A mandatory national program where each facility reviews quality and focuses on at least one area

10 Why do we need QuILTSS? Key is to link money earned to quality delivered Reward person-centered, high quality, high-value health care outcomes for all Tennesseans. Over the next three to five years, majority of healthcare spending in Tennessee will be based on paying for quality, outcomes, and value Better use of limited resources Quality Payment

11 Paying for Performance is Not a New Idea Others States With Similar Programs California Colorado Georgia Indiana Iowa Kansas Maryland Massachusetts Minnesota Ohio Oklahoma Texas Utah Virginia Washington

12 Different Approaches Among States Criteria GA KS IA MN OH OK CO UT MD Staff Stability/Retention X X X X X X X X Customer Satisfaction X X X X X X X X Regulatory Compliance X X X X X X X Employee Satisfaction X X X X X Culture Change/Person- Centered Care X X X X X Direct Care Staffing Levels X X X X X Quality of Clinical Care X X X X Quality of Life X X X X High Medicaid Occupancy X X X X Staff Training & Development Total Occupancy X X X X

13 We Need Your Help Measure Quality Clinically or Holistically?

14 Defining Quality in TN Do These Items Matter to You? Person-Centered Care Culture Consumer choice in the provision of their care Meaningful Day/Activities Health and Wellness Nursing Home and HCBS Work Force Staffing levels, retention, satisfaction, training Nursing Home Building and Grounds Clinical Outcomes Discharge to Home

15 Desire To Do QuILTSS Right Study best practices and research on what other states have done Interview a wide range of experts, consumers, and providers in other states to understand what has worked Seek input from individuals and entities most impacted by program Community Forums, Survey

16 Lipscomb University s School of TransformAging Role Engage key stakeholders in the program design process Assist in gathering input/information Make recommendations to TennCare based on feedback and research

17 Your Role Help us with the design process by adding your thoughts in a productive manner Encourage interested friends, neighbors, and colleagues to complete online survey

18 Survey