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The following post was written by Samadhi Moreno, Healthcare Research Associate at RMS.

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I recently listened to a new AHRQ Podcast on the common concerns and misconceptions regarding the CAHPS surveys. The title of the podcast series was “CAHPS Surveys: Sorting Fact from Fiction” by Rebecca Anhang-Price.

CAHPS results are used for pay per performance measures and are publicly reported to encourage consumer’s involvement in their healthcare and promote quality improvement initiatives. Survey results impact reimbursement, so it is important to understand the common misconceptions providers may have regarding CAHPS surveys.

Some of the important points of the podcast include:

  • It is a common misconception that patient surveys do not provide valid information about care quality. The Institute of Medicine identifies patient centeredness as an important element of quality of care. The CAHPS surveys offer valid and reliable data to measure patient centeredness and patient experience.
  • CAHPS surveys measure patient experience, which is an important factor in quality of care that can only be measured by patient surveys. Good patient experience is correlated with good clinical outcomes, and is the reason CAHPS surveys are used for payment programs and performance measures.
  • CAHPS Survey offer patients an opportunity to voice their opinions. The results in contrast, help patients choose a provider based on the experience of care.
  • There seems to be a common misconception on whether patients are “knowledgeable” enough to report good care. However, if we take a look at the CAHPS surveys, these instruments ask patients to report on their experience of care. Patients are the best source for this type of information because they experience the care first hand. The CAHPS surveys do not assess any type of technical work, but rather complement existing technical measures.
  • Patient’s experience is not influenced by whether the physician chooses a treatment protocol that fulfills the patient desires, but focuses on how well the providers communicate about the treatment option chosen. There is no evidence that offering unnecessary care will increase CAHPS scores in providers.
  • There are certain strategies physicians can utilize to improve patient experience, such as:
    • Involving the patient in the decision making process
    • Discussing the context of the patient’s requests
    • Proposing alternatives to patient requests
  • Lastly, providers might be concerned with how the patient population served can affect the providers CAHPS scores. However, CAHPS scores included in the publically reported results are case-mix adjusted to account for the variation in the populations served by physicians.

Research & Marketing Strategies (RMS) is a full service marketing and market research and consulting firm located in Baldwinsville, NY. As an approved CAHPS Vendor,  RMS’ Healthcare Department is composed of two divisions:(1) Healthcare Analytics and (2) Healthcare Practice Transformation. The Healthcare Analytics team is responsible for several aspects of the CAHPS Survey Administrations including the following product lines:  HCAHPS®, HH-CAHPS®, CG-CAHPS®, and ICH CAHPS®. The Practice Transformation team handles the coordination of quality initiatives to assist clients achieving Patient Centered Medical Home (PCMH) recognition. To learn more about our healthcare services, contact Sandy Baker, Senior Director of Business Development & Corporate Strategy at SandyB@RMSresults.com or by calling 1-866-567-5422. Visit our website at www.RMSresults.com.

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The following post was written by Samadhi Moreno, Healthcare Research Associate at RMS.

The Agency for Healthcare Research and Quality (AHRQ) recently announced a new exciting research project titled: “Using Patient Experience Information in Hospitals: A survey of Hospital Quality Leaders.” The project aims to answer the following questions:

  • How do hospitals collect patient experience data?
  • How do HCAHPS results influence a hospital’s efforts to improve patient experience?
  • What types of QI activities do hospitals implement to impact their HCAHPS scores?
  • Does hospital leadership see the value in HCAHPS scores?

AHRQ interviewed hospital quality leaders, hospital staff, hospital quality consultants, and HCAHPS vendors to determine potential survey topics. Using the results from these interviews, the AHRQ team developed potential questions to include in the survey. These questions were then used in the two additional rounds of cognitive interviews that were conducted with hospital quality leaders for feedback to then develop the survey instrument.

The survey instrument developed by AHRQ collects information about the hospital and the respondent on the following topics (2016):

  • Collection of HCAHPS and supplemental data for assessing patient experience
  • Activities to improve patient experience
  • Reporting of HCAHPS and other patient experience
  • Perspectives on HCAHPS
  • Institutional priority given to patient experience
  • Incentives, accountability, and compensation for patient experience scores

This survey will be administered to 500 hospitals of varying sizes and performance levels that publicly report HCAHPS scores and were part of the American Hospital Annual Survey.

Why is this important?

The results of this survey will provide information regarding the activities hospitals implement to improve HCAHPS scores. This can be useful for hospitals that are lagging in terms of patient experience and CAHPS scores. CAHPS surveys score aspects of care that can be helpful for health care executives to improve patient experience. The HCAHPS survey collects information on the patient experience regarding topics such as: the care from nurses, the patient experience in the hospital and after discharge, the overall hospital rating, and the understanding of his/her health once at home.

Many organizations have implemented products and services to improve the CAHPS scores in their organizations. CMS HCAHPS scores can be compared across hospitals regardless of patient mix; therefore the results of this study can be helpful for hospitals to improve bottom box scores.

The full research summary can be accessed here.

Research & Marketing Strategies (RMS) is a full service marketing and market research and consulting firm located in Baldwinsville, NY. As an approved CAHPS Vendor RMS’ Healthcare Department is composed of two divisions:(1) Healthcare Analytics and Healthcare Practice Transformation. The Healthcare Analytics team is responsible for several aspects of the CAHPS Survey Administrations including the following product lines HCAHPS®, HH-CAHPS®, CG-CAHPS®, and ICH CAHPS® and (2) Practice Transformation which handles the coordination of quality initiatives to assist clients achieving Patient Centered Medical Home (PCMH) recognition. To learn more about our healthcare services, please contact Sandy Baker, Senior Director of Business Development & Corporate Strategy at SandyB@RMSresults.com or by calling 1-866-567-5422. Visit our website at www.RMSresults.com.

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The following blog post was written by Hilary Ranucci, Business Development Coordinator at RMS.

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RMS continues to expand their abilities and is pleased to announce that we are a Centers for Medicare and Medicaid Services (CMS) approved vendor of the Consumer Assessment of Healthcare Providers and Systems® (CAHPS®) for Outpatient and Ambulatory Surgery (OAS) survey! RMS has almost a decade of experience in CAHPS survey administration, and is highly skilled in the collection of data and reporting along with a high response rate.

While participation in the OAS CAHPS survey is voluntary for 2016, we expect it to become mandatory in coming years. However, there are benefits to beginning the process early before it’s mandated. Benchmarking and baselines will become established for your organization as well as being able to improve service by learning from patient feedback. You’ll also become familiar with the process and be well prepared for when it does become mandated.

The OAS CAHPS survey will be implemented in January 2016 and surveying will be conducted on a monthly basis, similar to the hospital H CAHPS survey. RMS is able to offer multiple modes of surveying that best meet the needs of your organization. For more information about the OAS CAHPS survey process, qualifications, and quality measures, click here.

RMS has assisted hospitals, accountable care organizations, physician practices, home health and hospice agencies, and in-center hemodialysis facilities set a benchmark for current patient satisfaction in order to improve overall patient satisfaction.

RMS Healthcare is an approved vendor for the OAS CAHPS surveying process. In fact, RMS is approved for seven variations of CAHPS surveying! For more information or to request a proposal, please contact Sandy Baker, our Senior Director of Business Development & Corporate Strategy at SandyB@RMSresults.com or by calling 1-866-567-5422. Visit our website at www.RMSresults.com.

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The following blog post was written by Al Tripodi, Quality Auditor Associate at RMS.Confidential computer-breach

It’s probably not surprising that there has been an increasing number of HIPAA Breaches across the country. There is no question that as you hear of these breaches, you consider how to put more rigor around prevention. Here are 12 best practices that can “guide you and your company to a caring, compliant response, one that creates the most positive outcomes for everybody involved.”1

Step 1: Assemble incident facts.

Collect and produce digital data to be analyzed. Be sure to inventory the data and establish a chain of custody to track original media. Create a sound image of the original media for analysis with a backup copy. If possible, perform data analysis under attorney-client privilege.

Step 2: Examine the data.

Use the data to determine the facts of the potential breach, such as: was it benign or malicious; who was affected; source of the breach; data types, such as name, social security number, credit card number, health insurance information, etc.; level of exposure; third-party involvement; and whether the data was accessed or extruded.

Step 3: Document all findings.

Documentation should be presented in a clear, defensible way that can be upheld in courts of law and enforcement agencies. Record every action taken during data analysis. It’s important to understand the difference between an incident and a breach. Not every security incident is a data breach. A security incident is a violation of an organization’s security or privacy policies involving sensitive information. A data breach, on the other hand, is a security (or privacy) incident that meets specific legal definitions as per state and federal breach laws.

Step 4: Perform an incident risk assessment.

Use the findings of your data analysis to conduct an incident risk assessment to determine whether the privacy or security incident is a data breach that legally requires notification. Check to see if the breach meets the safe harbor requirements, which may exempt you from notification. Even if an incident is not a notifiable breach, consider risks to affected individuals and the reputation of your company if the breach is discovered and you choose to not notify.

Step 5: Stay up-to-date with the latest federal, state, and international laws.

The findings of your data analysis must be assessed against the most current breach notification regulations to determine if you have a notifiable breach on your hands. Multiple laws may apply to a single breach, depending on where you conduct business and/or the affected individuals reside. Regulations such as the HIPAA Final Rule have specific requirements and thresholds for when and how to notify affected individuals and the media. Forty-seven states and three territories have their own requirements for breach notification, which can often be more stringent than federal laws.

Step 6: Prepare to meet burden of proof.

Whether or not you choose to provide notification, regulators will want to know the reasons for your decision. Document all your findings and reports to support your burden of proof. You will have to demonstrate that you have a consistent, defensible method for incident risk assessment to show due diligence and regulatory compliance.

Step 7: Engage appropriate outside partners.

Outside parties such as your outside counsel, and insurance broker can drastically cut the cost and impact of breach response. Trusted vendors can help you meet legal requirements, protect potential victims, and preserve your company’s reputation. Select and contract with these vendors ahead of time, so they’ll be ready to team up with your internal incident response team if a breach occurs. Ask your broker to notify the insurance carrier of a breach to maximize applicable coverage. Engage outside counsel as soon as possible so all communications and documentation are protected under attorney-client privilege.

Step 8: Tailor your notification and response to the specifics of the incident.

Your breach response plan should be based on the demographics, customer relationships, and risk information of the affected population, to meet individual needs and best demonstrate compliance. Use current best practices, such as those offered here, for planning your breach response. Avoid copying the response of other companies. Their situation is not your situation. Keep the end customer in mind when formulating a response. If you were affected by a breach, how would you like to be treated?

Step 9: Ensure completeness of response.

These include: breach response project management; crisis PR; notification to the breached population, regulatory agencies, and the media; call center services and website; appropriate identity protection and monitoring; identity recovery services.

Step 10: Notify affected individuals, regulatory agencies, and the media.

Notify affected individuals, regulatory agencies, and the media in compliance with the latest regulations. All communications should be consistent and specific to the incident, and should include details of the breach, containment measures, ongoing investigation, services offered to affected individuals, and contact information. Have counsel review all notification communications to ensure compliance information. Notify all relevant federal and state agencies. These may include the Department of Health and Human Services (HHS), the Federal Trade Commission (FTC), and the Attorney(s) General of the state(s) where you do business and/or where the affected population resides. Have sufficient resources in place to ensure prompt, appropriate notification, such as scalable call-center services, crisis public relations, etc.

Step 11: Provide the appropriate identity monitoring and protection.

Victims of a healthcare data breach, for example, need protection for their medical records as well as any financial information. In these situations, credit monitoring is not enough. Match your identity monitoring and protection offer to the type of data breached: medical identity monitoring for healthcare, credit monitoring for a financial breach, etc. Encourage your customers to be proactive about protecting their identities with educational resources and self-monitoring tools.

Step 12: Provide identity recovery services for victims of identity theft.

Helping the customers or patients whose identities have been stolen is the highest priority. Ask your insurance broker to recommend an insurance provider that provides identity reimbursement insurance. Provide either in-house or outsourced identity recovery experts to assist victims. Plan to assist with every aspect of identity recovery, from resolving disputes, filing complaints, and providing limited power of attorney.

With careful planning and the help of trusted experts, you can successfully mitigate the damage of a breach and provide the most positive outcomes for your company, its reputation, and your customers.

RMS Healthcare can provide consultation and training services to ensure HIPAA Privacy and Security Compliance within your organization. If you would like to learn more about HIPAA Privacy and Security Compliance or further discuss how RMS Healthcare can help you, contact our Senior Director, Healthcare Operations and Compliance, Susan Maxsween at SusanM@RMSresults.com or by calling (315) 635-9802.

Source: IDExperts: 12-Step Program for Data Breach Response

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blog-pcmh-pediatriciansPediatricians associated with a practice that is a recognized Patient-Centered Medical Home (PCMH) by the National Committee for Quality Assurance (NCQA) can now be awarded Maintenance of Certification (MOC) credit by the American Board of Pediatrics (ABP). MOC is designed by and for pediatricians to encourage lifelong learning, self-assessment, and a continuous commitment to quality. NCQA’s mission is to improve quality of health care through measurement, transparency, and accountability. Clearly, the organizations are aligned with their commitment to quality driven healthcare.

ABP announced that affiliated pediatricians will be awarded 40 points toward Performance in Practice certification requirements. This is in recognition of the quality improvement initiatives associated with PCMH practices, and designed to reduce the duplication of reporting requirements needed for both programs. It is estimated that 8,000 doctors can earn credit based on their PCMH recognition. NCQA has recognized over 10,000 practices as patient-centered medical homes, of which approximately one third are pediatric practices.

NCQA is in the process of redesigning the PCMH recognition program to better align reporting requirements with government regulators and other organizations, with the goal of streamlining practices’ reporting and giving providers more time for patient care. NCQA is also working with other certifying organizations to encourage them to award their members credit for PCMH recognition.

Are you a pediatrician thinking about becoming a Patient-Centered Medical Home? With key decisions to allow MOC credit for recognized pediatricians, this may be the time to move forward with your goals. If you are interested in pursuing PCMH recognition, RMS Healthcare can help you transform your practice, allowing you to take advantage of current and future incentives. We have successfully assisted pediatric practices in achieving recognition through NCQA, and are pleased to share this MOC update with you. If you are interested in learning more about how we can help your practice, please contact Susan Maxsween, Sr. Director of Healthcare Operations and Compliance at SusanM@RMSresults.com or at 1-866-567-5422.

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RMS is pleased to announce that we have been approved for a second year as a Centers for Medicare and Medicaid Services (CMS) vendor of the Consumer Assessment of Healthcare Providers and Systems® (CAHPS®) for Accountable Care Organizations (ACOs) survey! RMS is in its ninth year of CAHPS® survey administration, and is highly experienced in the collection of data and reporting.

Here are important dates to keep in mind if you are looking for a CAHPS® for ACOs vendor:

  • September 22, 2015— Deadline to authorize approved survey vendor
  • November 13-16, 2015 — Beginning of survey administration process
  • February 3, 2016 — End of survey administration process
  • February 12, 2016 — Submission of survey data to CMS by survey vendor

RMS has assisted hospitals, accountable care organizations, physician practices, home health and hospice agencies, and in-center hemodialysis facilities set a benchmark for current patient satisfaction in order to improve the overall patient experience. The following areas are covered in the CAHPS for ACOs survey:

  • Getting timely care
  • Between-visit communication
  • Provider communication
  • Health promotion and education
  • Access to specialists
  • Rating of provider
  • Shared decision-making
  • Patient resources
  • Care coordination
  • Courteous/helpful office staff
  • Health/functional status
  • Medication adherence

For more information about the CAHPS® for ACOs survey process, qualifications, and quality measures, click here.

RMS Healthcare is an approved vendor for the CAHPS® for ACOs surveying process, as well as five other CAHPS® surveys! In addition to CAHPS surveying, RMS Healthcare has a full complement of consulting services available within the healthcare industry. For more information, please contact the Senior Director of Business Development & Corporate Strategy, Sandy Baker at SandyB@RMSresults.com or by calling 1-866-567-5422.

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The following blog post was written by Al Tripodi, Quality Auditor Associate at RMS.

HIPAA Privacy and Security Compliance is paramount to health care organizations, as well as any vendors or associates which have access to Protected Health Information (PHI). Violation of HIPAA can lead to termination of employment, large financial fines, and even jail time. The following is a story that reflects on a recent HIPAA compliance issue featured in the news.

One Florida-based hospital may be in some serious HIPAA hot water after an employee reportedly leaked an NFL player’s confidential medical record to the press. An employee at Jackson Memorial Hospital allegedly leaked the medical record of Jason Pierre-Paul, the defensive lineman for the New York Giants, to an ESPN reporter and analyst, Adam Schefter, who then posted a portion of the player’s medical record online at Twitter. The medical record confirmed that Pierre-Paul had his right finger amputated at the hospital, reportedly attributed to a July 4th fireworks mishap.

ESPN is not considered a covered entity or business associate under HIPAA, but Jackson Memorial Hospital is indeed “bound by the law” and thus liable for HIPAA privacy and security violations.

“The hospital, its employees and staff, and other covered entities and business associates have the obligation not to release PHI without the patient’s consent,” said David Harlow, principal at healthcare law and consulting firm The Harlow Group, in an emailed statement. “A journalist doesn’t have that obligation, nor does his network.”

Now it becomes a question of how the ESPN reporter got a hold of Pierre-Paul’s medical record in the first place. “The hospital staffer who likely provided it is the one who has violated HIPAA,” Harlow explained. And if that individual is indeed an employee of the hospital, Jackson Memorial could be in some big trouble too. HIPAA violation fines can reach $50,000 per violation, with a $1.5 million annual maximum.

The hospital launched an “aggressive internal investigation looking into these allegations,” said Carlos A. Migoya, president and CEO of Jackson Health System, in a statement. “If we confirm that Jackson employees or physicians violated a patient’s legal right to privacy, they will be held accountable, up to and including possible termination. We do not tolerate violations of this kind.”

If an investigation confirms that a hospital employee did provide this medical record to the press without Pierre-Paul’s consent, this would be a violation of HIPAA. And it wouldn’t be the health system’s first HIPAA breach. In fact, over the last four years, Jackson Health System has reported three large HIPAA breaches, according to data from the U.S. Department of Health and Human Services.

RMS Healthcare, a division of RMS in Baldwinsville, NY can provide HIPAA training for your organization to heighten awareness and to ensure you have the processes in place to mitigate risk.  We can assist your organization in developing and implementing policies and procedures that align with the Omnibus rulings. We can provide you and your health care organization all the HIPAA policies, procedures, and forms needed. If you would like to learn more about HIPAA Privacy and Security Compliance or further discuss how RMS Healthcare can help you, contact our Senior Director, Healthcare Operations and Compliance Susan Maxsween at SusanM@RMSresults.com or by calling (315) 635-9802.

Here are links to additional information if you would like to read more:

http://money.cnn.com/2015/07/08/media/jason-pierre-paul-espn-adam-schefter-hipaa/

 http://www.healthcareitnews.com/news/hospital-hipaa-trouble-after-reports-nfl-medical-record-leak

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The following blog post was written by Heather Banks, a Healthcare Transformation Coordinator at RMS.

Care Coordination is paramount to ensuring management and delivery of quality-centered patient-care. The goal of care coordination is to make the primary care practice the hub of all patient care. Not only must care coordination be within the practice, but in order to effectively coordinate patient care, the primary care practice must develop relationships between the community setting, hospitals, labs and specialists. They must create protocols to support successful referrals and transitions; and develop systems to handle the transfer of pertinent information. The responsibility of PCMH is not just to inform those community providers, but to reach out and connect with them in meaningful and impactful ways so that information is communicated appropriately, consistently and without delay. Putting a care coordination program or care coordinator in place will significantly improve quality of care and patient satisfaction. Utilizing the expertise of a Care Manager will significantly contribute to improved quality of care; patient outcome, and could positively impact a patient’s overall experience.

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To improve accountability and prevent care from being fragmented, consider these five steps:

  • Assign a dedicated person/team to be accountable for managing patient care.
  • Define the extent of responsibilities for key activities.
  • Establish when specific responsibilities should be transferred to other providers whether that means specialty physicians, long-term care facilities, or home care providers.
  • Share clinical information and findings about patients who are in the hospital.
  • Ensure that referrals to specialist physicians are made and completed.

Providers need to understand why this is so important to their practices. In some instances, communication breaks down between the providers and facilities; which can lead to unnecessary hospitalizations, duplicate tests and procedures, medical and medication errors, among other problems. Having a Care Coordinator in place reduces these risks and healthcare costs by preventing avoidable hospitalizations and emergency room use.

There are four key steps that a primary care setting need to do to implement Care Coordination within the practice setting:

  • Assume Accountability
    • Decide to improve care coordination.
    • Develop a quality improvement plan to implement change.
    • Develop a tracking system to internally track and manage the referral process and transition of care.
  • Provide Patient Support
    • Train the care team in effective communication and in their duties in order to support patients and families.
    • Assess patient’s clinical needs as well as insurance and logistical needs.
    • Identify patient barriers and help address them. Be sure the patients are well informed and help them understand the reason for the referral to an outside specialist or other facility.
    • Engage the patients to talk about their care after a hospitalization or ER visit, ask them if there have been any visits to specialists or behavioral health professionals. Also ask if any medication changes have occurred outside of the PCPs office.
    • Provide the patient with a discharge check list preparing them to leave a hospital or long-term care facility.
    • Communicate patients’ needs and preferences to all staff providing care.
    • Ensure the care team follows-up with the patient post-hospitalization or ER visits within an appropriate period of time. Educate the patient on the appropriate usage of the ER or if it is something that should be taken care of in the primary care setting.
    • Identify barriers or problems that will prevent the patient from not keeping their referral appointment.
  • Build Relationships and Agreements
    • Develop and maintain relationships with key specialists, hospitals and community agencies. Become the building block for these relationships with these providers and facilities.
    • Develop verbal or written agreements that include expectations and guidelines for referral and care transition processes to keep all parties informed of any clinical developments and to ensure compliance.
    • Set clear expectations on how information will be shared.
    • Make sure the referring and consulting providers understand the importance of the referral, and the roles that each will play in providing care by implementing a standard communication protocol.
    • Be sure the information in the referral requests and consultation reports meets agreed expectations.
  • Develop Connectivity
    • Establish an EHR system that can share information so that accurate and updated patient information can be sent easily to other providers.
    • Enable live data-sharing so physicians can immediately see changes in medications and test results.
    • Establish the ability to send alerts to providers when patients have been seen to the hospital so they can follow up.
    • Implement an information transfer system and assign specific individuals on the care team to help patients and their information get where it needs to go.
    • Designate an on-site staff member who will be an expert in the EHR system and can trouble shoot problems.
    • Open communication with other providers about patients as a way of two-way communication to follow up on information received through the EHRs.

Effective communication is the foundation of any health care team. Errors in communication can have grave consequences in the health care setting. Everyone in the health care community has a role to play by working together to achieve exceptional care coordination. Practicing effective care coordination will provide significant benefits to the implementing practice.

RMS Healthcare, a division of Research and Marketing Strategies, Inc. (RMS) has over 50 years of collective and proven experience in providing consulting services to meet the specific needs of our clients. Regardless of your healthcare research or practice transformation needs, RMS Healthcare can help.  If you are interested in learning more, please contact Susan Maxsween, Senior Director, Healthcare Operations and Compliance at SusanM@rmsresults.com or via telephone at 1-866-567-5422.

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RMS is pleased to announce that we are a Centers for Medicare and Medicaid Services (CMS) approved vendor of the Consumer Assessment of Healthcare Providers and Systems® (CAHPS®) for Physician Quality Reporting System (PQRS) survey! RMS is in its ninth year of CAHPS® survey administration, and is highly experienced in the collection of data and reporting.

Here are important dates to keep in mind if you are looking for a CAHPS® for PQRS vendor:

  • September 22, 2015— Deadline to authorize approved survey vendor
  • November 16, 2015 — Beginning of survey administration process
  • February 3, 2016 — End of survey administration process
  • February 12, 2016 — Submission of survey data to CMS by survey vendor

For more information about the CAHPS® for PQRS survey process, qualifications, and quality measures, click here.

RMS has assisted hospitals, accountable care organizations, physician practices, home health and hospice agencies, and in-center hemodialisysis facilities set a benchmark for current patient satisfaction in order to improve overall patient satisfaction.

RMS Healthcare is an approved vendor for the CAHPS® for PQRS surveying process. In fact, RMS is approved for six variations of CAHPS® surveying! For more information or to request a proposal, please contact the Senior Director of Business Development & Corporate Strategy, Sandy Baker at SandyB@RMSresults.com or by calling 1-866-567-5422.

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The following blog post was written by Karen Joncas, a Healthcare Transformation Coordinator at RMS.

The National Committee for Quality Assurance (NCQA) Patient-Centered Connected Care™ (PCCC™) standards are now available for non-traditional practices wishing to seek recognition of their quality-driven patient care. NCQA is offering this program in response to the plethora of choices that patients have in seeking episodic care as well as the need to emphasize the importance of clinical integration and communication in the medical neighborhood. Being recognized affirms that the non-traditional practice is working within the framework of the medical neighborhood, effectively communicating and sharing patient information with primary care practices. Eligible practices include urgent care centers, onsite employee health clinics, and school-and-retail-based clinics.

Sites that wish to be recognized will need to meet a minimum score across five standards. Unlike Patient-Centered Medical Home™ (PCMH™) recognition, there are no levels of recognition status; either a practice is recognized or it is not. Practices will be evaluated on five program standards including:
1.    Connecting with Primary Care
2.    Identifying Patient Needs
3.    Patient Care and Support
4.    System Capabilities
5.    Measure and Improve Performance

RMS Healthcare can assist providers in non-traditional and traditional practices in their transformation journey and/or NCQA recognition. Practices or providers interested in PCCC can purchase the standards and obtain more information from NCQA’s website. If you are interested in learning more, please contact Susan Maxsween, Sr. Director of Healthcare Operations and Compliance at SusanM@RMSresults.com or at 1-866-567-5422.

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