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How CMS is Integrating Quality into Programming

How Is CMS Integrating Quality?


The Centers for Medicare & Medicaid Services (CMS) has been placing a strong emphasis on integrating quality into its priority programs. This approach reflects CMS's commitment to ensuring high standards across healthcare facilities, benefiting both patients and organizations alike. Our very own Tammy Cassidy, Senior Practice Director, of Engage Consulting outlines the evolution of quality measures and the benefits for providers to place a renewed emphasis on quality.


The Importance of Timing in Quality Measures

Timing is everything when it comes to quality measures, especially given the delayed effect these measures can have. Quality metrics often rely on data from previous quarters, meaning that the efforts you put in today might not show immediate results but will significantly impact future outcomes. For example, if you're reviewing a 5-star report for the second quarter of 2024, the most recent data might be from the fourth quarter of 2023. This delay highlights the need for proactive engagement with quality measures to avoid compounded negative effects on outcomes.


Complexity and Evolution of Quality Measures

Quality measures are inherently complex and continuously evolving. For instance, the transition from section G to section GG in the Minimum Data Set (MDS) required interdisciplinary teams to adapt to new coding practices and learn five new quality measures. This ongoing evolution means that healthcare providers must stay vigilant and continuously educate their teams to keep up with new and revised measures, such as the discharge function score or updates to long-stay pressure ulcer metrics.


Navigating the Overlap Between Federal and State Programs

In addition to keeping up with federal guidelines, interdisciplinary teams must also navigate the overlap between federal and state programs. Balancing financial outcomes with quality metrics can be challenging, but it is possible with a deep understanding of how these programs interact. Teams that excel in this area can achieve great results in case mix, 5-star ratings, and outcomes for various payers and networks.


The Benefits of Focusing on Quality

Improving focus on quality offers numerous benefits. At the core, being best-in-class for quality enhances the well-being of residents and elevates the organization's reputation. This, in turn, leads to better survey results, more stable census, and improved financial performance. Moreover, staying aligned with CMS initiatives, such as the testing of risk-based surveys, can provide additional advantages, including shorter survey durations for high-quality facilities.


Real-World Impact of Quality Initiatives

Recent CMS initiatives, like the discharge function score, measure the progress residents make during their skilled time in a facility. The Engage Consulting team has been instrumental in training therapy teams and provider organizations, leading to remarkable improvements. Facilities have reported significant progress in the percentage of residents meeting or exceeding CMS expectations before discharge, showcasing the tangible benefits of prioritizing quality.


Complementary Quality Assessment

We are dedicated in helping providers achieve excellence in quality care. That’s why we’re offering a complimentary quality assessment to help you identify areas for improvement and align with CMS’s new rigorous standards. Our expert team will provide personalized insights and actionable strategies to elevate your facility’s performance. Don’t miss this chance to enhance your quality measures—contact us today to schedule your complimentary assessment and take the first step toward becoming a best-in-class provider!


Get in touch by emailing info@conceptrehab.com.



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