Good Samaritan Shares Positive Value Based Purchasing Results

The Good Samaritan Board of Governors learned Thursday evening that Good Samaritan outperformed the state and national averages in Value Based Purchasing (VBP). Mike Smith, Director of Performance Excellence/Patient Safety, presented Good Samaritan’s positive Value Based Purchasing results during the board meeting.

VBP is a Federal program designed by the Centers of Medicare and Medicaid (CMS) to add value to health care purchasing. Nearly 3,000 hospitals nationwide participate in the VBP program.

Each year Medicare holds back 2 percent of every hospital’s annual Medicare reimbursement and then, depending on the hospital’s performance in a given year, each hospital can earn-back some, all, none, or more than that holdback. A hospital's earn-back is based on their performance in areas such as: Safety, Mortality (Survival as calculated by CMS), and Patient experience. For the 2016 performance year, CMS held back $492,268 from Good Samaritan. In the payment year 2018 (beginning October 1, 2017), CMS will pay Good Samaritan back $597,190. That equates to a positive gain for Good Samaritan of $104,922.

For the performance year 2016 (payment year 2018), Good Samaritan outperformed that national and state average with a total score of 41.96. The state average is 38.03 and the national average is 37.43. Good Samaritan is also performing at or close to the top national rate for Acute Myocardial Infarction (AMI) and survival rate for pneumonia. The hospital’s AMI rate is 86.67 percent and survival rate for pneumonia is 90 percent, while top national rates are 87.31 percent (AMI) and 90.79 percent (pneumonia).

Good Samaritan's patient experience scores have also led to a high VBP score. On the CMS designed HCAHPS (Hospital Consumer Assessment of health care Providers and Systems) survey, Good Samaritan has seen a 3 percent increase in Communication with Doctors and a one percent increase in Overall Hospital Rating questions.

Smith says the largest area of performance improvement in VBP has been in the safety measures. “We showed an 18% improvement in our patient safety indicators, which include nine patient safety metrics. We are also proud to have sustained a rate of zero percent for early elective delivery, meaning that there has been no baby deliveries occur by choice between 37 and 39 weeks gestation. Research has shown that women who do not deliver before 39 weeks gestation are more likely to have healthier babies,” commented Smith. “There are also five safety metrics associated with hospital-acquired infections that we have showed improvements in over our baseline.”

Compared to the hospital’s baseline, Good Samaritan showed a 54 percent improvement in Catheter Associated Urinary Tract Infection, Central Line Associated Blood Stream Infection remained at zero, Clostridium Difficile Infection improved 14 percent, Methicillin Resistant Staphylococcus Aureus (MRSA) improved by 67 percent, and surgical site infections – colon improved by 40 percent.

"What all of this means for our community is that Good Samaritan is providing very good value when it comes to health care services,” Smith stated. "All of these metrics are true indicators of how hospitals are providing safe and quality care. The staff of Good Samaritan have worked and continue to work very hard to maintain the improvements we have seen, as well as to continue the improvements into the future."

The Good Samaritan infection prevention improvements have been accomplished through diligent work by staff, collaboration with state and federal agencies, and by reviewing and utilizing industry best practices. The improvements in the safety and quality metrics essentially drive some of the other improvements such as mortality (survival) and patient experience.

Also during the board meeting, Chief Nursing Officer, Karen Haak and Director of Perioperative Services, Brenda Winkler, were joined by Mako Specialist, Ted Powell, to demonstrate the advanced capabilities of the Mako Robotic Arm for hip and knee replacements.

The robotic arm technology is an innovative tissue-sparing procedure, with implants designed to result in a more natural feeling joint replacement. It offers a less surgically invasive option and promotes a quicker recovery time while having the potential to decrease the patient’s length of stay in the hospital.

Using a virtual 3D model, the Mako System allows surgeons to personalize each patient’s surgical plan pre-operatively, so there is a clear plan for how the surgeon will position the implant before entering the operating room. During surgery, the surgeon can make any necessary adjustments with the help of the robotic arm to execute the surgical plan with a high level of accuracy and predictability. The combination of these three features of the system has the potential to lead to better outcomes and higher patient satisfaction.

The board also approved the purchase of new Alaris infusion pumps for all inpatient and outpatient intravenous infusions. The current Alaris pumps used by the hospital will no longer have Guardrails software updates after 2018, which is used by Alaris devices to ensure safe administration of medications, blood products, and nutrition. The software has a library of infusions given at Good Samaritan programmed into each individual device. The library warns and stops clinicians from beginning infusions that are beyond the recommended dosing. “This will be a necessary purchase to ensure patient safety and quality,” said Haak.

Because the board agreed to purchase this 2018 budgeted item this September, Good Samaritan will be able to acquire the equipment for a discounted amount of $798,200; saving approximately $180,450-$265,549 based on the estimate prices could be in 2018.

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