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Posted May 14, 2013 | comments Leave a comment

Valley Health shifts from volume to value

By Kim Walter

WINCHESTER -- Members of the Valley Health Corporation got a glimpse into the system's definition of value during their annual meeting at Winchester Medical Center on Tuesday afternoon.

Following a few recognitions and a brief look back at the past year, Chris Rumpf, senior vice president and chief quality and medical officer, presented his take on Valley Health's shift from volume to value.

Rumpf admitted that the recent health care changes have left him "tired and weary," as Valley Health has had to change its way of thinking.

"Up until this point, hospitals were driven by more and more volume generating more and more revenue," he said. "This has changed. We've moved from getting paid for volume to getting paid for value."

Since the system's success hinges on that definition of value, Rumpf described the organizations attempting to define it. He said the Centers for Medicare and Medicaid Services was one leader in establishing a number of programs that define value, including value-based purchasing and readmission penalties.

"I am especially weary of the new inpatient perspective payment rules," he said. "The number of measures has escalated, and they are based on the outcome rather than the process."

Rumpf said rules are being changed on "just about everything." He added that it doesn't help when Medicare and Medicaid establish new requirements and policies, only to let the health care provider know after the provisionary period has already ended.

"It's sort of like a game of gotcha," he said.

One piece of the puzzle is how Valley Health will collect necessary information from patients and employees. Rumpf said for the past six months, the system has reevaluated its method.

Valley Health thought it was taking a step forward by increasing the rate at which information was checked.

"We were checking charts, we were checking in with doctors, check, check, check," Rumpf said. "Well, that's not going to work. We've learned why, in that regard, information systems are so important."

Between the increase in penalties, take backs around value-based purchasing and the sequester, Rumpf said he feels the "federal government is using CMS as a way to deflate the health care system."

Valley Health's definition of value, as described by Rumpf, is a combination of initiatives involving zero harm, great patient and family experiences, and no waste.

"I'd like to tell you we're there, but we're not, and neither is anyone else in the state," he said of the values.

Rumpf said it would be impossible to result in absolutely no waste, and that the goal factors in more than just physical waste. It also means looking at the patient perspective, and making a conscious effort to not waste their time or efforts.

"This will take some realignment of how we think," he said.

Valley Health is striving to be a high reliability organization, Rumpf said, which he explained through a quote.

"'Where what should happen, does happen, and where what should not happen, does not,'" he said. "The last few words of that quote, which are very important, are 'every time.'"

Rumpf said reaching the goal would be "quite the task," but added that a committee is already in place to make it happen. The focus of that group will be on creating a safety culture, rigorous quality improvement and driving leadership to the caregivers.

The safety culture involves asking the system's physicians and leaders to highlight any potential safety risks as soon as they are aware of them so that the committee can begin taking care of it.

"We want to look at these issues before something actually goes wrong," Rumpf said. "It's often the people actually working in the clinic who pick up on these signals, and we need their help more than ever to continue on this path."

Contact staff writer Kim Walter at 540-465-5137 ext. 191, or kwalter@nvdaily.com

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