Content by Keyword: Access

The central themes regarding aspects of the Maryland quality initiatives that were less successful were around communication of quality initiatives with the Ombudsman, provider access to funding, and the minimum staffing requirement. With the exception of one person we spoke with (a supervisor), Ombudsman were not at all familiar with the Second S

The Ombudsman stated that regulations alone are not enough to improve quality. She believes that multiple and varied approaches must be utilized to assist facilities in their quality efforts. Adequate numbers of, and respect for, staff is one such area. Another approach involves improving access for facilities to clinical informational resources a

No evaluation of the impact of these programs has been made to date. Some decrease in the number of deficiencies has been noted in recent years, but it is not clear that there is any connection between the quality improvement programs and the number of deficiencies cited. Although there are statistics available on how many people access the websit

Although there was agreement that nursing facilities appreciated recognition for good performance, there was concern expressed by the Ombudsman that these awards gave consumers a false sense of security. In their experience, they noted that consumers seeing a Best Practice icon on the website or a Deficiency Free Certificate assumed that the facil

Provider representatives overwhelmingly agreed that recognition programs (Deficiency Free Certificates, Governor's Quality Award, and Best Practices) did much to boost nursing facilities' morale. Over and over, participants stated that in the heavily regulated and scrutinized nursing home environment, facilities were grateful for positive recognit

Much of the feedback aimed at the Federal Government concerned the issue of reimbursement. One provider representative summed it up by saying that "You cannot separate money from care," and that Medicare and Medicaid programs have to pay reasonably for reasonable care. There has to be more emphasis on alternative care (home care, assisted living)

No formal evaluation of Florida's quality improvement programs has been performed to date. AHCA staff reported that they are interested in evaluating the success of the programs, particularly the TA component. However, because the programs have been operating only a short time, it is not yet possible to evaluate their impact. Because many of the p

Although some discussion participants praised the Quality Monitoring program, consumer advocates voiced some concerns, primarily because of the changes that were made to the original role and responsibilities as laid out in HB 1971 in 1999. The program as initially enacted was seen as separate from the survey agency and allowed the monitors to foc

The  Florida Nursing Home Watch List  is published by the AHCA to assist consumers in evaluating the quality of nursing home care in Florida (see App endix C  for an excerpt of the most recent Watch List).

Accountable Care Organization (ACO)

TABLE L-1. Standards Available to Support HIE of LTPAC Data

TABLE K-1. HIE Activities for Transitions of Care

Description of ACO Measures: Excerpts and Table from CMS "Accountable Care Organization 2013 Program Analysis--Quality Performance Standards Narrative Measure Specifications" Report

EMHS is an innovative organization providing industry leadership on how LTPAC providers and technology can be integrated into new care delivery and payment models. Their patient-centered approach to care coordination embraces the spectrum of providers and integration of community services. Technology plays an important role in coordination of care

Barriers to Expansion of Telehealth . The use of telehealth has shown promise for improving patient care management, outcomes and cost, but EMHC identified challenges with the reimbursement structure coupled with high cost of the equipment create challenges for expanding the technologies use across a broader population with a large, rural geog

TABLE J-7. HIE by Care Coordination Function and Partners, Eastern Maine HomeCare EMHC does not report or identify any specific HIE measures. They report the 33 required quality measures as a Pioneer ACO. These measures are detailed in Attac   hment J-1.

EMHC staff described the clinical workflow processes for care and how information is used and exchanged. Table J-6 describes the process, information collected and/or exchanged and observations by staff. TABLE J-6. Home Health Care Workflow Processes

The availability, use and exchange of information is crucial for an EMHC to begin care and coordinate care with other service providers. Information exchange occurs through multiple different methods -- via phone, photocopies, fax and e-mail as well as through access to the hospital EHR, customized portals and the HIE. This section describes HIE i

The EMHS's IS department in collaboration with EMHC have identified three priority projects currently under development. The following projects, once complete, will improve EMHC's interoperability and HIE capabilities:

TABLE J-5. EMHC Software Applications