It’s Time to S.H.I.F.T.
Our New Reality – Change! Was there ever a time that was more uncertain than today in our industry? Everything we read about, hear about and talk about in post-acute care is change. Between last week and this current week, the Centers for Medicare and Medicaid Services (CMS) has announced significant initiatives that will impact post-acute care leaders beginning FY 2019 (October 1, 2019) through press releases, as well as the Open-Door Forums held this week. Announcements impacting clinical and financial outcomes included:
- Proposed Rule – Patient-Driven Payment Model (PDPM) – New Case Mix payment system replacing RUGs system.
- SNF VBP – Beginning 10/1/18 with 2% payment withholding related to SNFRM.
- SNF VBP Quarterly and Annual Confidential Feedback Reports – Currently in place. Organization data impact financial and clinical outcomes.
- IMPACT Act – Transfer of Health Measures.
- SNF QRP Updates – Confidential Feedback Reports and Quality Measure updates impacting clinical and financial outcomes.
- PBJ Updates – Five Star and Survey Process.
Preparing for and managing change is about how we as leaders handle the complexity of the process. Many leaders, like myself, have found that we are in a position of learning while leading. As health care leaders we must evaluate, plan and implement tactics, strategies and operational processes to exceed the expectations of health care today and in the future – we need to S.H.I.F.T. to prepare for change.
Seek – Knowledge and clear understanding of the regulatory, reimbursement and quality measurement changes and their defined impact on our organization is key to determining the foundation for actions needed within our organization.
How – With your team, ask “How will this affect our organization?” to identify organization readiness for change. What systems, processes, services and resources will be needed, refined or changed due to the reimbursement, regulatory and quality measure changes coming in FY 2019 and beyond?
Information – Review current organization data and the confidential reports from CMS with your team. Align your current data outcomes with the proposed changes. Additionally, use the CMS Confidential feedback report in SNFVBP and SNFQRP programs (located in the report section of CASPER/QEIS systems) to identify organization trends, variances, spikes in outcomes and the current impact to clinical and operational and financial outcomes.
Formulate – Formulate the vision and goals for change. Based upon your review of the upcoming changes, organization readiness and organization data, develop an action plan with your team. Determine priorities (immediate vs. important), what is immediate (which will have a serious and immediate negative impact) and what is important (that which needs to be accomplished, however there are possibly a few more days to complete some of the tasks). Priorities may include financial analysis, education at all levels of the organization, as well as internal and external resources that will be needed to lead the organization to successful outcomes.
Team – In today’s world – it takes a team. Track and trend outcomes to the strategies implemented in your action plan as well as your organization data outcomes. There are numerous changes and “to dos” that require yourself as a leader as well as various team members for input, skill sets and knowledge. You cannot do this alone – engage a team from all levels of your organization to review the changes, trend current and potential outcomes as well as solicit your team’s thoughts and ideas.
With the health care environment increasing in complexity, transforming the way we lead and how health care is delivered and managed within our organization and in collaboration with our partners is the key to success. The key competitive advantage today is the ability to change, adapt and evolve – SHIFT in order to achieve sustainable and successful outcomes.
Author: Lisa Thomson,
Chief Marketing and Strategy Officer,