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Value-Based Purchasing (VBP) Implementation at Willis Knighton Medical Center

In the contemporary healthcare environment, insurers have shifted from rewarding healthcare organizations based on the number of services that they deliver. The focus by insurers such as Medicare and Medicaid Services (CMS) is now on the hospital value-based purchasing (HVBP) program (Jha, 2017). In specific, insurers are using financial incentives in the quest to improve the performance of healthcare providers. The VBP program serves to improve the treatment incomes of the US patient populations via the reimbursement of health care providers based on a specific scale which is commensurate with the service quality of the organizations (Phillips, 2015). VBP initiatives have been found to promote quality health and ensure that patients get value from the medication treatments. According to Ryan et al. (2017), some of the benefits of VBP include reduction in costs, increment in patient satisfaction, reduction in medical errors, and promotion of healthy habits. This paper provides an evaluation of VBP in Willis Knighton Medical Center, a general medical and surgical facility in Shreveport, Northwestern Louisiana.

A1. VBP Degree of Implementation

The HVBP total performance released by CMS shows that Willis Knighton Medical Center has a score of 86.6 in terms of the unweighted normalized clinical care. Notably, the organization has significantly implemented VBP. The organization has ensured that its members of staff have the right tools which make them manage alternative payment models. Additionally, the Center had developed various key performance indicators (KPIs) which ensures that it maximizes its reimbursements (Bloomberg, 2018). Some of these include the rates of patient satisfaction and the rates of medical errors. The Medical Centre believes that if they measure it, then they can be able to manage it. The development of these KPIs has enabled the organization to quantify its performance according to various care quality and cost management metrics. Additionally, it has continuously monitored its progress and achieved positive outcomes. However, much needs to be done in Willis Knighton Medical Center in terms of implementation, especially in some of the value-based metrics such has preventative screening and management of different conditions.

B1. Departments Impacting VBP

In any healthcare organization, various departments will have a huge impact when VBP is implemented. For the case of Willis Knighton Medical Center, VBP implementation will have the most impacts in the finance department, quality control department, and the HR departments. Notably, Jha (2017) states that one of the main benefits of VBP is the reduction in healthcare costs. The finance department will ensure that there is an alignment of finance with quality. In specific, budgetary allocations will be assigned to those areas where there is need for quality improvements. However, the quality control department will be instrumental in ensuring that some of the VBP metrics are achieved (Ryan et al., 2017). In specific, it will be key to ensuring a reduction in medical errors and increment in patient satisfaction which are key areas of focus by VBP. Finally, the HR departments require various actions to be taken by staff members to ensure compliance with the Centers for Medicare & Medicaid Services (CMS) standards (Phillips, 2015). As such, the department will be instrumental in ensuring that the various actions align with the required VBP guidelines.

B1a. Explanation of Roles and Functions

The three departments where VBP will have the most impact will serve different functions during the implementation. The finance department will have the role of providing the necessary resources which will be used in the implementation process. The resources will include financial ones as well as HR (Phillips, 2015). During implementation, there will be a need for hiring of trainers who will provide staff members with education in various ways for the adoption of VBP. However, the HR department will provide the necessary human resources for the implementation of VBP. For instance, there will be a need for the deployment of qualified staff members who will be vital in the implementation process (Jha, 2017). Moreover, additional members of staff will be required especially to ensure the attainment of the required staff to patient ratio. Finally, the role of the quality control department will be to measure the various metrics and ensure that they are in line with the CMS’s provided guidelines.

B2. Goals for Each of The Three Departments

Each of the three departments will have different goals in furthering the implementation of VBP in Willis Knighton Medical Center. The finance department will have the goal of aligning finance with quality. In specific, the aim will be to ensure that any costs expedited to specific activities within the hospital result in the provision of high-quality services. Ryan et al. (2017) opine that the finance department will have the goal of ensuring that there is a proper disbursement of finances in the healthcare organization based on the need for quality improvements in different departments. The HR department, on the other hand, will have the goal of ensuring that the members of staff possess the prerequisite skills and competencies for the implementation of VBP (Nilsson et al., 2017). As such, it will have the goal of providing the necessary skills. Finally, the HR department will have the goal of getting the right people who can implement VBP smoothly. However, according to Phillips (2015), the quality control department will aim at ensuring that quality metrics are followed and achieved. The department will measure the quality metrics and compare them with the CMS required ones.

B3. Attaining Quality

Each of the goals of the finance, HR, and quality control department will help attain quality outcomes in both patient care and reimbursements over the next three years. The goals of the finance department of aligning finance with quality will ensure the provision of quality services which will translate to positive patient outcomes (Aroh et al., 2015). With positive patient outcomes, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHP) scores will increase and hence increased reimbursement. For the goals of the HR department of ensuring proper implementation of CMS’s requirements, the recruitment of highly qualified staff members coupled with the training of the existing will translate to better care delivery and hence fewer medical errors resulting in better patient outcomes and increased reimbursements. Finally, the goals of quality control will be to measure performance metrics and ensure that they align with those of CMS (Jha, 2017). The goals will result in patients getting quality services and make Willis Knighton Medical Center get increased reimbursements over the next three years.

B4. Critical Key Points

            For Willis Knighton Medical Center’s strategic plan, the members of staff will have to understand various key points. One of the points is that they will have to improve on the current performance so that it aligns with the requirements of VBP. As such, according to Aroh et al. (2015), they should be prepared to embrace various quality improvement strategies based on peers and national benchmarks. Moreover, Powers (2018) asserts that staff members will have to embrace the new measures aimed at clinical and financial improvement. The employees will have no note that there will be changes which will be made and should thus embrace the changes so that value-based performance can be achieved. Embracing change will include appreciating the change in the status quo and avoiding any resistance which will impede the proposed changes (Ryan et al., 2017). Finally, the employees should get the critical point that the VBP program implementation will be gradual and will require the cooperation of all staff members.

B4a. Marketing the Key Points

As the members of staff at all levels of management will require education on the new value-based reimbursement environment, marketing the key points of the strategy will require the use of different techniques. One of those will be via face-to-face conversations in boardrooms. In such meetings, the key points will be marketed to the staff members (Aroh et al., 2016). In specific, they will be explained the nature of changes which will take place and why they need to adopt the VBP program. Marketing will also be done via the use of posters and brochures which will be provided to the members of staff. In the brochures and posters, the need for the change will be presented as well as the benefits which will arise from the adoption and implementation of VBP in Willis Knighton Medical Center (Kondo et al., 2016). Such marketing techniques will be instrumental in convincing the member of staff about the importance of VBP.

B5. Ethical Clinical and Ethical Business Practices

Various ethical clinical and ethical business practices will be incorporated into the strategic plan. Some clinical ethical practices include the provision of patient-centered care which will be emphasized in the VBP component of improving the patients’ experience of care.  Additionally, it will be emphasized that nurses will practice with compassion and respect the inherent dignity and uniqueness of the patients based on the US American Nurses Association (ANA) Code of Ethics (Bailes et al., 2014). Ethical business practices include increasing profitability while providing quality services to clients. Additionally, the practice of rewarding performance and penalizing failure will be an ethical business practice.

B6. Coordinating Events

In the coordination of the various events of the strategic plan, the three departments of finance, HR, and quality control will have various meetings whereby they will discuss issues of common interests (Harrison et al., 2017). The staff members of the departments as well as the leaders will have face-to-face meetings whereby they will identify aspects which need to be addressed and ways in which they can work together towards the achievement of the goals of the strategic plan (Kondo et al., 2016). Through effective communications, which will extend beyond face-to-face meetings and involve the creation of a WhatsApp group for the staff of the three departments, will be critical in sharing information necessary for the coordination of the three departments.

B7. Timeline

C1. Most Pertinent Components

The most pertinent VBP components in Willis Knighton Medical Center include the patients’ experience of care, clinical outcomes, and efficiency aspects. In specific, the organization has experienced decreased rates of satisfaction due to high rates of medical errors as well as poor service delivery. As such, the VBP will have the component of ways to increased HCAHP scores, especially through improved quality of service and keeping the patients engaged about their own health. In addition, the clinical outcomes; especially the patient-reported outcomes, are poor. As such, the VBP will have the component of ways that the clinical outcomes will be improved especially the quality of services offered. The final component will be increased efficiency, considering that in Willis Knighton Medical Center, there is a lot of wastage on resources which will need to be reduced via the use of VBP.

C2. Preparation for Implementation

In the next three years, the three departments of finance, HR, and quality assurance will need to prepare adequately for the implementation of VBP. The preparation for implementation will require the finance department allocating the necessary financial resources for the implementation. Such resources will go towards the hiring of experts in VBP implementation as well as recruitment of additional members of staff. The HR department will have to prepare by adding the members of staff who possess the necessary skills and competencies vital for the implementation. Additionally, the HR department will provide training and education to the employees in the manner of implementation. The quality control department will prepare by stating the quality thresholds which will need to be reached by the staff members after the implementation. The preparation will require the quality control department to identify areas which require improvement and the specific quality improvements which should be made.

C3. Necessary Education and Training

All the levels of management, including the physicians and staff of Willis Knighton Medical Center, will require education and training in the new value-based reimbursement environment. The training will increase their competencies and thus decrease any resistance to change. In the finance department, the staff members will be educated on ways of cutting costs. However, the HR department will provide training to members on ways that the staff members can collaborate in the actual implementation of the VBP components. Staff in the quality assurance department will receive education and training on how to measure specific performance measures which are required by the CMS in value-based purchasing.

In conclusion, the main goals of VBP include lowering of healthcare costs while improving patient outcomes. Willis Knighton Medical Center has taken significant steps towards the implementation of a VBP program. However, it will need to implement a strategic VBP program over the three years which will improve the patient experience of healthcare, reduce costs, and increase efficiency. The three departments, which will most impact VBP implementation, are the finance department, the HR department, and the quality control departments. The final department will provide the required financial resources, while the HR department will deploy the required members of staff. The quality control department will establish performance metrics which will be achieved after the implementation of the strategic VBP program. The goals of the departments will be to ensure the success of the VBP implementation. In preparation for the implementation, the finance department will allocate resources whereas the HR department will provide training and education to the members of staff on how they will implement the CMS requirements of VBP. Events of the implementation will be coordinated through face-to-face meetings as well as via a WhatsApp group involving the members of the relevant departments.