Outcomes Management Flashcards
Outcome =
Results, final product, end result, goal
Outcome management
managing for results
Process of continually measuring practice and program to make sure desired results are being achieved
Like taking a selfie - gives you perspective
Outcome management assists in
Driving business decisions
Developing budgets and allocating resources
Assessing practice patterns
Inc understanding of practice variables
Determining if clinic is effective and efficient
Why outcomes management is needed
Provide needed evidence on impacts
Create learning organizations
Pt and 3rd party payer demanding quality of care
Identify issues
Assist in providing right care for every pt
Questions outcomes management can ansuwer
Is there a need for change
Should clinic start a new service, stop one, hire new
Improving performance should be congruent with established practice patterns
Adv to outcomes management
Inc knowledge of processes
Improved care
Improved functional outcomes
Identifies training opportunities
Disadv to outcomes management
Infrigement on tx time
Pressure to inc productivity
Difficulty ensuring reliability during data colelction
3 key areas of outcome management
Financial outcomes
Satisfaction outcomes
Clinical performance
Financial outcomes - goal
Provide services customers want
Cost effective
Revenue meets expenses and provides profit
Financial outcomes - useful data - key financial indicators
Gross profits
Net profits
Accounts receivable (money that a clinic is owed
Financial outcomes - standardization
Work relative value (WRV) to standardize comparison between clinicians/clients
Weight of procedures which accounts for variations in skill, effort, payment rates
Financial outcomes - standardization - Work relative value - Timed CPT code
weight of 1
Financial outcomes - standardization - Work relative value - Initial eval
Weight of 3
Financial outcomes - standardization - Work relative value - modalities
weight of 0.5
Financial outcomes - standardization - Work relative value - hot/cold packs
weight of 0.25
Satisfaction outcomes - foal
Identify actions to provide services that are satisfactory to patient
Satisfaction outcomes - key factors
Communication Consistency Respect Attention Understanding Competency
Clinical performance (functional outcomes) goals
Improved care or optimal service (effective and efficient)
Can guide learning/training
Evaluate clinical performance
Target continuing education
Market effectiveness to payers, referral sources and consumers
Prepare for value based care
Differentiate self and negotiate payer contracts in regards to quality rather than lower price
Clinical performance (functional outcomes) - useful data
Need adequate measurement of baseline, intervention performed, condition of pt after intervention
Clinical performance (functional outcomes) - Standardization of care
Done by clinical practice guidelines, critical pathways, care maps and protocols
Process of measuring and managing outcomes
Identify population to be studied Choose outcome measurement tool Collect admission data Collect clinical intervention data Collect discharge data Analyze and interpret data Develop actions based on data analysis Implement the actions Evaluate the outcomes program
Commercial outcome systems - AM PAC
Activity measure for post acute care Measures in 3 areas - basic mobility - daily activities - applied cognitive
Commercial outcome systems - Care connections
Measures
- functional improvement
- decrease in pain
- return to work and utilization
Commercial outcome systems - FOTO
Focus on therapeutic outcomes inc
3 scores (initial, during, final)
Score 0 to 100 functional ability
Uses 10 risk adjusted factors to assist in accuracy for benchmarking
Commercial outcome systems - OPTIMAL
Outpatient PT improvement in movement assessment log
Measures 22 movements in functional activities
Recommended by CMS as an assessment tool to document objective and measurable function
Commercial outcome systems - PROMIS
Pt reported outcome measurement information system
Measures adult and children physical, mental and social health
