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Healthcare Org 1, 1.20 (R) [INFO] Topic 5 - Healthcare Organization Characteristics

1.20 (R) [INFO] Topic 5 - Healthcare Organization Characteristics

Topic 5. What are the major characteristics of healthcare organizations? Healthcare organizations, like all organizations, can be described by their characteristics, but there is no one official list of characteristics to describe an organization. There is no one official list of the importance of each characteristic. You can decide on the characteristics to describe a healthcare organization and the relative importance of each characteristic. For example, you could decide that in your evaluation of healthcare organizations, the most important characteristic is whether the employee cars in the parking lot are clean and neat. A host of one of the home renovation shows once said that the most important characteristic in choosing a good tenant is whether the tenant applicant's car is clean and neat. The host's experience was that those people who keep a car – regardless of the car's age and value – clean and neat will keep the rental unit clean and neat. People who respect their car will respect their rental unit. In the host's opinion, a tenant should be selected based on the cleanliness and neatness of the applicant's car. You may decide, therefore, that healthcare organization employees who respect their cars by keeping them clean and neat will respect their workplace and its customers/patients. You may decide that you will choose a healthcare organization based on the cleanliness and neatness of the employees' cars. Despite differences of opinion on the characteristics and their importance in describing organizations in general and healthcare organizations specifically, there is general agreement that those characteristics can be organized into three broad categories: Healthcare Organization Structure Characteristics Healthcare Organization Process Characteristics Healthcare Organization Performance Characteristics More information about each of these three broad categories is found below. Note [FUN]: Links within this section lead to external [FUN] readings not needed for the certificate work. You do not have to visit these external links. Do so only if you have the interest and the time. Note [CERT]: Pay attention to the text in bold. It just may be included on the [CERT] Lesson One Quiz. Healthcare Organization Structure Characteristics Structure characteristics are those which describe the basic static form of the healthcare organization (internal characteristics) and where it "lives" (external characteristics). It is not unlike describing the physical characteristics of an animal which lives in the wild and its habitat. For example, The Smithsonian's National Zoo and Conservation Biology Institute has a Giant Panda Fact Sheet which describes the Giant Panda's basic static form (Internal Characteristics: Physical Description, Size) and where it “lives” (External Characteristics: Native Habitat). As a side note, there is also a Giant Panda Cam where you can watch the National Zoo pandas which are a symbol of “cross cultural collaboration between the United States and China” . The following are examples of healthcare organization characteristics which most people would consider structure. It is not a complete list. You may have others which you would add to this list. Governance Structure (Internal Characteristic) Facilities Structure (Internal Characteristic) Workforce Structure (Internal Characteristic) Legal/Regulatory Structure (External Characteristic) Local Health Geography Structure (External Characteristic) Marketplace Structure (External Characteristic) Governance Structure This topic is discussed in Week 3, Lesson 3 of this course. Facilities Structure Facilities structure refers to the physical characteristics of the healthcare organization (e.g., how many buildings, how many beds). The architectural design of healthcare organization facilities is a specialized field. The Healthcare Design website, magazine and events focus only on this specialty. Workforce Structure Workforce structure refers to the number of people working in the healthcare organization, their distribution across space and time (e.g., emergency room, night shift), and their work focus/responsibility (occupation). The Bureau of Labor Statistics (BLS), Occupational Outlook Handbook (OOH) provides information about Healthcare Occupations, the training required for each, and the median annual wage. Legal/Regulatory Structure The legal/regulatory structure for healthcare organizations is extensive. Generally speaking, the legal structure is divided into three categories: health law (government law regarding organizations), medical law (rights of patients), and public health law (government law regarding populations).Becker's Hospital Review devotes an entire section to Legal and Regulatory Issues for the healthcare industry especially hospitals. The U.S. Department of Health and Human Services (HHS) also devotes a section of its website to Laws and Regulations associated with HHS. Local Health Geography Structure The local health geography structure for healthcare organizations not only includes the organization's physical geographic location (e.g., state, city), but also the way in which that physical geographic space affects the health of the local population most likely to be customers (patients) of the healthcare organization. The interaction between health and location is the basis for the County Health Rankings and Roadmap which provides a "revealing snapshot of how health is influenced by where we live, learn, work and play". Marketplace Structure The structure of a healthcare organization's marketplace has a major impact on an organization. If there are many competitors offering the same products/services and few customers/patients, the healthcare organization may not have a high probability of staying in business. But many think that too little competition in the marketplace is bad for customers/patients. Some articles have been published on the issue of the marketplace and competition. Some of them are listed below. However, each is optional; you do not have to read it. Competition in the Healthcare Marketplace Healthcare Needs Real Competition Competitive Markets in Health Care: The Next Revolution The Cure for Health Care is Competition

Healthcare Organization Process Characteristics Process characteristics are dynamic characteristics that describe what the organization does within and using the structure characteristics. In short, process characteristics are what the people within the healthcare organization (both paid and volunteers) do - how they spend their time in support of the organization's mission, vision, and goals. The following are examples of healthcare organization characteristics which most people would consider process. It is not a complete list. You may have others which you would add to this list. Administration and Management Processes Health Care Delivery Processes Human Resources Processes Business Processes Financial Processes Quality Improvement Processes Administration and Management Processes This topic is discussed in Week 2, Lesson 2 of this course. Health Care Delivery Processes Health care delivery processes are the way in which the people in the healthcare organization process customers (patients) when they arrive, are provided health care, and when they leave. For healthcare organizations, these are the "manufacturing processes"; the processes by which the organization's "products" are "manufactured". Some may consider it odd to think of health care delivery processes in terms of the manufacturing processes, but some healthcare organizations have successfully used manufacturing processes to improve health care delivery. The two most commonly used manufacturing-related processes in health care are Six Sigma developed at Motorola and Lean which has its foundation in the Toyota Production System. More information about Lean can be found at the Lean Enterprise Institute (LEI) website. There is even an organization which advocates the combination of the two approaches; the Lean Six Sigma Institute (LSSI). Some articles have been published on the application of Six Sigma and Lean to health care delivery. Some of them are listed below. However, each is optional; you do not have to read it. How a Manufacturing Process Transformed Healthcare Delivery Lean Management – The Journey from Toyota to Healthcare The Applicability of Lean and Six Sigma Techniques to Clinical and Translational Research Lean and Six Sigma in Acute Care: A Systematic Review of Reviews (Pubmed Listing Only) Two examples of health care delivery processes are: 1) health care delivery capacity utilization (e.g., how many of the available/capacity emergency room beds are utilized by a patient); and 2) delivery of specific health care treatments. Human Resources Processes Human resources processes are the way in which employees of an organization are hired, managed, and developed. Two examples of the human resources processes are: 1) development of orientation programs and training for new hires in the organization; and 2) development of employee compensation and benefits criteria. The American Society for Healthcare Human Resources Administration (ASHHRA) is a professional association only for healthcare human resources professionals. Business Processes The American College of Healthcare Executives (ACHE) defines business processes as the processes which pertain to “specific areas/concepts of the organization.” Examples of such processes are marketing, business planning, strategic planning, crisis management, and risk management. In short, businesses processes are those processes which enable the organization to work as an efficient and effective organizational system rather than as a set of independent departments. Such independent departments are often termed “silos” and, in healthcare organizations, silos are the norm. Organizational silos exist when members of departments have a primary loyalty and identification with their department and departmental co-workers rather than with the organization as a whole. Members of a silo do not like to share resources (e.g., information, supplies, ideas) with those outside the department. Business processes can be designed in one of two ways regarding silos: 1) to reduce or eliminate silos; or 2) to connect and manage silos. In the first situation (reduce or eliminate), silos are considered bad and an organizational flaw. Silos must be eliminated if the healthcare organization is to function well. This approach agrees with the Business Dictionary which states that a Silo Mentality “will reduce efficiency in the overall operation, reduce morale, and may contribute to the demise of a productive company culture” . Such business processes attempt to blur departmental boundaries and encourage people to identify with the healthcare organization as a whole rather than with their department or healthcare profession. The focus on interprofessional education and practice in healthcare organizations is also an attempt to reduce or eliminate healthcare silos. The National Center for Interprofessional Practice and Education is a great resource for more information on such interprofessional healthcare efforts. In the second situation (connect and manage), silos are considered good or at least an unavoidable functional outcome of an organization comprised of highly specialized and trained professionals. This approach believes that silos must be networked and managed – but not eliminated – if the organization is to function well. Such business processes connect and network silos to build bigger and bigger silos. Departments, for example, are networked to build a division. Divisions are networked to build an organization. Each silo is encouraged to be a high functioning unit (team) networked to other units (teams); the organization is a team-of-teams. The following articles discuss healthcare organization silos. You may find them interesting, however, each is optional; you do not have to read it. They are: Better Patient Flow Means Breaking Down Silos Breaking Down Silos to Improve Patient Flow, Hospital Efficiency Quashing the Silos and Getting to Integrated Health Care Breaking Down Silos Is a Myth, Do This Instead The Need for a Team of Teams It Takes a Team of Teams to Transform Healthcare Fixing Healthcare Safety: A Team of Teams Financial Processes Financial processes are the way in which the organization's finances are processed; from revenue to expenditures (and ensuring that expenditures do not exceed revenues). The person in charge of the organization's financial processes is usually the Chief Financial Officer (CFO). Two examples of financial processes are: 1) development of the organization's budget; and 2) development of financial reporting systems. Quality Improvement Processes Quality improvement processes are the way in which the organization gathers data on organizational characteristics, analyzes that data, and then makes changes (improvements) as necessary to better achieve organizational goals and objectives - to improve quality. Many use the National Academy of Medicine (NAM) - formerly the Institute of Medicine (IOM) - definition of healthcare organization quality which is "the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge". The Centers for Medicare and Medicaid Services (CMS) states that: "Both quality measurement and quality improvement increase the likelihood of desired health outcomes, using different but mutually supporting mechanisms ... The mechanism of quality improvement is standardization ...The mechanisms of quality measurement are selection and choice. A quality measure is used as a tool for making “good decisions” defined as decisions that make it more likely to experience a good result and less likely to experience an adverse result that was not foreseen or was not understood." (Website Source of Quote) Two quality measurement tools used by healthcare organizations are the: 1) Healthcare Effectiveness Data and Information Set (HEDIS) developed by the National Committee for Quality Assurance (NCQA) under a contract from CMS; and 2) CMS Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) which is pronounced H-caps and often referred to as the Hospital Survey or just H-caps.

Healthcare Organization Performance Characteristics Performance characteristics are dynamic characteristics that describe what the organization does within and using both the structure and process characteristics. Generally speaking, these can be divided into two different categories - although you may have others which you would add to this list: Financial Performance/Outcomes Product (Health Care Delivery) Performance/Outcomes Financial Performance/Outcomes The financial performance/outcomes of a healthcare organization can be found in an organization's financial statement and an external independent financial audit. In some cases, regulation requires that all corporate organizational public financial statements be ones that have been subject to an external independent financial audit. A for-profit healthcare organization's corporate credit rating such as one from FitchRatings or stock rating such as one from the Morningstar Rating for Stocks can also be considered financial performance/outcomes characteristics. For a non-profit healthcare organization, the financial health rating from Charity Navigator can be considered a financial performance/outcomes characteristic. Product (Health Care Delivery) Performance/Outcomes The product (health care delivery) performance/outcomes can be found in any number of ways. There are popular rankings to aid customer/patient decision-making such as that done by U.S. News and World Reports - Health which ranks/rates hospitals, doctors, and senior care based. The methodology for determining the rank/rating for hospitals is found at FAQ: How and Why We Rank and Rate Hospitals. Performance/outcome ratings to aid customer/patient decision-making are also produced by the Center for Medicare and Medicaid Services (CMS) through its Hospital Compare Overall Rating from one to five stars. Access to information about individual hospitals - information on a variety of measures as well as the performance/outcome rating - for comparison purposes is available from the Hospital Compare website. The Agency for Healthcare Quality and Research (AHQR) National Healthcare Quality and Disparities Reports (NHQDR) rates state-level health care quality relative to a set of benchmarks to help policy development. Some performance/outcomes are tied to health care delivery reimbursement. One example are the CMS Value-Based Programs which "reward health care providers with incentive payments for the quality of care they give to people with Medicare". Such value-based programs are often called pay-for-performance programs. The CMS value-based programs are: Hospital Value-Based Purchasing (HVBP) Program Hospital Readmission Reduction (HRR) Program Value Modifier (VM) Program (also called the Physician Value-Based Modifier or PVBM) Hospital Acquired Conditions (HAC) Program End-Stage Renal Disease (ESRD) Quality Initiative Program Skilled Nursing Facility Value-Based Program (SNFVBP) Home Health Value Based Program (HHVBP)

Note [FUN]: The video for Topic 5 - Value-Based Purchasing - is a YouTube video produced by the Washington State Health Care Authority as part of its Healthier Washington program. The video provides an overview of the fundamentals and philosophy of health care value-based purchasing.


1.20 (R) [INFO] Topic 5 - Healthcare Organization Characteristics 1.20 (R) [INFO] Tópico 5 - Características da organização dos cuidados de saúde

Topic 5. What are the major characteristics of healthcare organizations? Healthcare organizations, like all organizations, can be described by their characteristics, but there is no one official list of characteristics to describe an organization. There is no one official list of the importance of each characteristic. You can decide on the characteristics to describe a healthcare organization and the relative importance of each characteristic. For example, you could decide that in your evaluation of healthcare organizations, the most important characteristic is whether the employee cars in the parking lot are clean and neat. A host of one of the home renovation shows once said that the most important characteristic in choosing a good tenant is whether the tenant applicant's car is clean and neat. The host's experience was that those people who keep a car – regardless of the car's age and value – clean and neat will keep the rental unit clean and neat. People who respect their car will respect their rental unit. In the host's opinion, a tenant should be selected based on the cleanliness and neatness of the applicant's car. You may decide, therefore, that healthcare organization employees who respect their cars by keeping them clean and neat will respect their workplace and its customers/patients. You may decide that you will choose a healthcare organization based on the cleanliness and neatness of the employees' cars. Despite differences of opinion on the characteristics and their importance in describing organizations in general and healthcare organizations specifically, there is general agreement that those characteristics can be organized into three broad categories: Healthcare Organization Structure Characteristics Healthcare Organization Process Characteristics Healthcare Organization Performance Characteristics More information about each of these three broad categories is found below. Note [FUN]: Links within this section lead to external [FUN] readings not needed for the certificate work. You do not have to visit these external links. Do so only if you have the interest and the time. Note [CERT]: Pay attention to the text in bold. It just may be included on the [CERT] Lesson One Quiz. Healthcare Organization Structure Characteristics Structure characteristics are those which describe the basic static form of the healthcare organization (internal characteristics) and where it "lives" (external characteristics). It is not unlike describing the physical characteristics of an animal which lives in the wild and its habitat. For example, The Smithsonian's National Zoo and Conservation Biology Institute has a Giant Panda Fact Sheet which describes the Giant Panda's basic static form (Internal Characteristics: Physical Description, Size) and where it “lives” (External Characteristics: Native Habitat). As a side note, there is also a Giant Panda Cam where you can watch the National Zoo pandas which are a symbol of “cross cultural collaboration between the United States and China” . The following are examples of healthcare organization characteristics which most people would consider structure. It is not a complete list. You may have others which you would add to this list. Governance Structure (Internal Characteristic) Facilities Structure (Internal Characteristic) Workforce Structure (Internal Characteristic) Legal/Regulatory Structure (External Characteristic) Local Health Geography Structure (External Characteristic) Marketplace Structure (External Characteristic) Governance Structure This topic is discussed in Week 3, Lesson 3 of this course. Facilities Structure Facilities structure refers to the physical characteristics of the healthcare organization (e.g., how many buildings, how many beds). The architectural design of healthcare organization facilities is a specialized field. The Healthcare Design website, magazine and events focus only on this specialty. Workforce Structure Workforce structure refers to the number of people working in the healthcare organization, their distribution across space and time (e.g., emergency room, night shift), and their work focus/responsibility (occupation). The Bureau of Labor Statistics (BLS), Occupational Outlook Handbook (OOH) provides information about Healthcare Occupations, the training required for each, and the median annual wage. Legal/Regulatory Structure The legal/regulatory structure for healthcare organizations is extensive. Generally speaking, the legal structure is divided into three categories: health law (government law regarding organizations), medical law (rights of patients), and public health law (government law regarding populations).Becker's Hospital Review devotes an entire section to Legal and Regulatory Issues for the healthcare industry especially hospitals. The U.S. Department of Health and Human Services (HHS) also devotes a section of its website to Laws and Regulations associated with HHS. Local Health Geography Structure The local health geography structure for healthcare organizations not only includes the organization's physical geographic location (e.g., state, city), but also the way in which that physical geographic space affects the health of the local population most likely to be customers (patients) of the healthcare organization. The interaction between health and location is the basis for the County Health Rankings and Roadmap which provides a "revealing snapshot of how health is influenced by where we live, learn, work and play". Marketplace Structure The structure of a healthcare organization's marketplace has a major impact on an organization. If there are many competitors offering the same products/services and few customers/patients, the healthcare organization may not have a high probability of staying in business. But many think that too little competition in the marketplace is bad for customers/patients. Some articles have been published on the issue of the marketplace and competition. Some of them are listed below. However, each is optional; you do not have to read it. Competition in the Healthcare Marketplace Healthcare Needs Real Competition Competitive Markets in Health Care: The Next Revolution The Cure for Health Care is Competition

Healthcare Organization Process Characteristics Process characteristics are dynamic characteristics that describe what the organization does within and using the structure characteristics. In short, process characteristics are what the people within the healthcare organization (both paid and volunteers) do - how they spend their time in support of the organization's mission, vision, and goals. The following are examples of healthcare organization characteristics which most people would consider process. It is not a complete list. You may have others which you would add to this list. Administration and Management Processes Health Care Delivery Processes Human Resources Processes Business Processes Financial Processes Quality Improvement Processes Administration and Management Processes This topic is discussed in Week 2, Lesson 2 of this course. Health Care Delivery Processes Health care delivery processes are the way in which the people in the healthcare organization process customers (patients) when they arrive, are provided health care, and when they leave. For healthcare organizations, these are the "manufacturing processes"; the processes by which the organization's "products" are "manufactured". Some may consider it odd to think of health care delivery processes in terms of the manufacturing processes, but some healthcare organizations have successfully used manufacturing processes to improve health care delivery. The two most commonly used manufacturing-related processes in health care are Six Sigma developed at Motorola and Lean which has its foundation in the Toyota Production System. More information about Lean can be found at the Lean Enterprise Institute (LEI) website. There is even an organization which advocates the combination of the two approaches; the Lean Six Sigma Institute (LSSI). Some articles have been published on the application of Six Sigma and Lean to health care delivery. Some of them are listed below. However, each is optional; you do not have to read it. How a Manufacturing Process Transformed Healthcare Delivery Lean Management – The Journey from Toyota to Healthcare The Applicability of Lean and Six Sigma Techniques to Clinical and Translational Research Lean and Six Sigma in Acute Care: A Systematic Review of Reviews (Pubmed Listing Only) Two examples of health care delivery processes are: 1) health care delivery capacity utilization (e.g., how many of the available/capacity emergency room beds are utilized by a patient); and 2) delivery of specific health care treatments. Human Resources Processes Human resources processes are the way in which employees of an organization are hired, managed, and developed. Two examples of the human resources processes are: 1) development of orientation programs and training for new hires in the organization; and 2) development of employee compensation and benefits criteria. The American Society for Healthcare Human Resources Administration (ASHHRA) is a professional association only for healthcare human resources professionals. Business Processes The American College of Healthcare Executives (ACHE) defines business processes as the processes which pertain to “specific areas/concepts of the organization.” Examples of such processes are marketing, business planning, strategic planning, crisis management, and risk management. In short, businesses processes are those processes which enable the organization to work as an efficient and effective organizational system rather than as a set of independent departments. Such independent departments are often termed “silos” and, in healthcare organizations, silos are the norm. Organizational silos exist when members of departments have a primary loyalty and identification with their department and departmental co-workers rather than with the organization as a whole. Members of a silo do not like to share resources (e.g., information, supplies, ideas) with those outside the department. Business processes can be designed in one of two ways regarding silos: 1) to reduce or eliminate silos; or 2) to connect and manage silos. In the first situation (reduce or eliminate), silos are considered bad and an organizational flaw. Silos must be eliminated if the healthcare organization is to function well. This approach agrees with the Business Dictionary which states that a Silo Mentality “will reduce efficiency in the overall operation, reduce morale, and may contribute to the demise of a productive company culture” . Such business processes attempt to blur departmental boundaries and encourage people to identify with the healthcare organization as a whole rather than with their department or healthcare profession. The focus on interprofessional education and practice in healthcare organizations is also an attempt to reduce or eliminate healthcare silos. The National Center for Interprofessional Practice and Education is a great resource for more information on such interprofessional healthcare efforts. In the second situation (connect and manage), silos are considered good or at least an unavoidable functional outcome of an organization comprised of highly specialized and trained professionals. This approach believes that silos must be networked and managed – but not eliminated – if the organization is to function well. Such business processes connect and network silos to build bigger and bigger silos. Departments, for example, are networked to build a division. Divisions are networked to build an organization. Each silo is encouraged to be a high functioning unit (team) networked to other units (teams); the organization is a team-of-teams. The following articles discuss healthcare organization silos. You may find them interesting, however, each is optional; you do not have to read it. They are: Better Patient Flow Means Breaking Down Silos Breaking Down Silos to Improve Patient Flow, Hospital Efficiency Quashing the Silos and Getting to Integrated Health Care Breaking Down Silos Is a Myth, Do This Instead The Need for a Team of Teams It Takes a Team of Teams to Transform Healthcare Fixing Healthcare Safety: A Team of Teams Financial Processes Financial processes are the way in which the organization's finances are processed; from revenue to expenditures (and ensuring that expenditures do not exceed revenues). The person in charge of the organization's financial processes is usually the Chief Financial Officer (CFO). Two examples of financial processes are: 1) development of the organization's budget; and 2) development of financial reporting systems. Quality Improvement Processes Quality improvement processes are the way in which the organization gathers data on organizational characteristics, analyzes that data, and then makes changes (improvements) as necessary to better achieve organizational goals and objectives - to improve quality. Many use the National Academy of Medicine (NAM) - formerly the Institute of Medicine (IOM) - definition of healthcare organization quality which is "the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge". The Centers for Medicare and Medicaid Services (CMS) states that: "Both quality measurement and quality improvement increase the likelihood of desired health outcomes, using different but mutually supporting mechanisms ... The mechanism of quality improvement is standardization ...The mechanisms of quality measurement are selection and choice. A quality measure is used as a tool for making “good decisions” defined as decisions that make it more likely to experience a good result and less likely to experience an adverse result that was not foreseen or was not understood." (Website Source of Quote) Two quality measurement tools used by healthcare organizations are the: 1) Healthcare Effectiveness Data and Information Set (HEDIS) developed by the National Committee for Quality Assurance (NCQA) under a contract from CMS; and 2) CMS Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) which is pronounced H-caps and often referred to as the Hospital Survey or just H-caps.

Healthcare Organization Performance Characteristics Performance characteristics are dynamic characteristics that describe what the organization does within and using both the structure and process characteristics. Generally speaking, these can be divided into two different categories - although you may have others which you would add to this list: Financial Performance/Outcomes Product (Health Care Delivery) Performance/Outcomes Financial Performance/Outcomes The financial performance/outcomes of a healthcare organization can be found in an organization's financial statement and an external independent financial audit. In some cases, regulation requires that all corporate organizational public financial statements be ones that have been subject to an external independent financial audit. A for-profit healthcare organization's corporate credit rating such as one from FitchRatings or stock rating such as one from the Morningstar Rating for Stocks can also be considered financial performance/outcomes characteristics. For a non-profit healthcare organization, the financial health rating from Charity Navigator can be considered a financial performance/outcomes characteristic. Product (Health Care Delivery) Performance/Outcomes The product (health care delivery) performance/outcomes can be found in any number of ways. There are popular rankings to aid customer/patient decision-making such as that done by U.S. News and World Reports - Health which ranks/rates hospitals, doctors, and senior care based. The methodology for determining the rank/rating for hospitals is found at FAQ: How and Why We Rank and Rate Hospitals. Performance/outcome ratings to aid customer/patient decision-making are also produced by the Center for Medicare and Medicaid Services (CMS) through its Hospital Compare Overall Rating from one to five stars. Access to information about individual hospitals - information on a variety of measures as well as the performance/outcome rating - for comparison purposes is available from the Hospital Compare website. The Agency for Healthcare Quality and Research (AHQR) National Healthcare Quality and Disparities Reports (NHQDR) rates state-level health care quality relative to a set of benchmarks to help policy development. Some performance/outcomes are tied to health care delivery reimbursement. One example are the CMS Value-Based Programs which "reward health care providers with incentive payments for the quality of care they give to people with Medicare". Such value-based programs are often called pay-for-performance programs. The CMS value-based programs are: Hospital Value-Based Purchasing (HVBP) Program Hospital Readmission Reduction (HRR) Program Value Modifier (VM) Program (also called the Physician Value-Based Modifier or PVBM) Hospital Acquired Conditions (HAC) Program End-Stage Renal Disease (ESRD) Quality Initiative Program Skilled Nursing Facility Value-Based Program (SNFVBP) Home Health Value Based Program (HHVBP)

Note [FUN]: The video for Topic 5 - Value-Based Purchasing - is a YouTube video produced by the Washington State Health Care Authority as part of its Healthier Washington program. The video provides an overview of the fundamentals and philosophy of health care value-based purchasing.