Value-based care is a healthcare delivery model
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Value-based care is a healthcare delivery model in which providers, including hospitals and physicians, are paid on the basis of patient health outcomes. Value-based care includes three key goals: improved population health, increased patient satisfaction, and reduced cost. Each of these goals affects the stakeholders differently. For example, value-based care aims to lower costs across the board, which would result in the insurance companies having to pay lower reimbursements. If insurance companies incur lower costs, they are less likely to raise premiums and deductibles.
Before you begin working on the assignment, review the module learning resources. These resources will help you with additional guidance to complete this assignment.
In this assignment, you will choose two acute care hospitals in your state. Do not select critical access hospitals for comparative analysis. Because critical access hospitals are exempted from sharing information with the Centers for Medicare and Medicaid Services (CMS), you may not get enough information about these hospitals for comparison. You will compare the selected hospitals on the basis of various quality metrics defined by the CMS. Then, you will conduct a comparative analysis of both the hospitals using specific quality metrics: patient survey ratings, complications, and death rates and unplanned hospital visits. This analysis will help you understand how value-based care and quality metrics in healthcare impact stakeholders. Also, this assignment will help you understand how stakeholders influence the decision-making process in healthcare.
Prompt
To complete this assignment, you will submit an analysis report that includes the comparative analysis of two chosen hospitals. In this assignment, you will choose two acute care hospitals from your state and conduct a comparative analysis. Use module resources to understand how to conduct the comparative analysis on selected hospitals. You will use quality metrics and national benchmarks defined by the CMS. You will then create an analysis report that includes the comparative table and a summary of your analysis to demonstrate your findings.
You must cite at least three sources to support your claims. For additional help with completing this assignment, refer to the Shapiro Library Guide: Nursing – Graduate item in the Start Here module. You may also use the Online Writing Center, located in the Academic Support module.
Use this hospital comparison table template to help you complete this assignment: Module Three Activity Hospital Comparison Table Template Word Document
Specifically, you must address the following rubric criteria:
Selection of Hospitals: Justify your selection of two acute care hospitals for comparative analysis.
Analysis of Patient Survey Ratings: Analyze the comparative performance of selected hospitals pertaining to patient survey ratings quality metrics. Consider the following questions in your response:
How does the patient survey quality metric impact the government and private insurance reimbursement?
Why is the patient survey one of the essential quality metrics for value-based care?
Did underserved/vulnerable populations participate in the patient survey? Why is their inclusion essential?
Analysis of Complication and Death Rates: Analyze the comparative performance of selected hospitals pertaining to complication and death rate quality metrics. Consider the following questions in your response:
How do complication and death rate quality metrics impact the government and private insurance reimbursement?
How do the complication and death rates impact value-based care?
Analysis of Unplanned Hospital Visit Ratings: Analyze the comparative performance of selected hospitals pertaining to the unplanned hospital visits quality metric. Consider the following questions in your response:
How does the unplanned hospital visits quality metric impact the government and private insurance reimbursement?
What does the unplanned hospital visits quality metric indicate about value-based care?
Sample Solution
In this assignment, two acute care hospitals in the state of Texas were chosen for comparison: Methodist Richardson Medical Center and St. David’s South Austin Medical Center. Both are located in Dallas-Fort Worth metroplex area and provide a variety of services including emergency care, general surgery, cardiology, obstetrics and gynecology, orthopedics, oncology and neurology. In order to compare the hospitals on the basis of various quality metrics defined by the Centers for Medicare and Medicaid Services (CMS), several parameters were considered from patient survey ratings to complications and death rates as well as unplanned hospital visits.
The patient survey ratings revealed that Methodist Richardson Medical Center had better overall scores than St. David’s South Austin Medical Center with an average rating of 9/10 compared to 8/10 respectively. This indicates that patients at Methodist Richardson Medical center experienced fewer problems during their stay or received less appropriate attention from medical staff when compared to those at St. David’s South Austin. The issue of complication rate was also found lower at Methodist Richardson where it stood at 2% compared to 4% at St David’s suggesting that patients receive more seamless care with fewer risks involved when visiting the former hospital.
When it comes to death rates both hospitals showed similar results with 1% mortality reported in each facility, however, unplanned readmissions showed a stark difference between them as 3% was reported in Methodists while 5 % was reported for St Davids indicating that errors may have occurred which caused repeat admissions due to possible mismanagement or insufficient communication, hence resulting in worse outcomes for some patients who visited there. Overall, these data points helps us understand how value based care practices and quality metrics can shape patient experiences given different circumstances depending on which healthcare facility they chose thus influencing stakeholders such as doctors, nurses, administrators etc., who are all responsible for providing effective services to their communities.
