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Oaklawn to invest in patient services with insurer’s incentive reward

MARSHALL – Oaklawn Hospital’s excellent quality scores will translate into improved health services for its patients, hospital officials say.

The hospital recently received a check for $231,516.56 – a quality-incentive payment from Grand Rapids-based Priority Health.

Molly McCarthy, the insurer’s associate vice president, wrote in a letter to the hospital that the award recognized Oaklawn’s efforts to provide high-quality care to the community during calendar 2013.

Ginger Williams, Oaklawn’s President and CEO, said the funds will be used to support educational opportunities for hospital staff. Those opportunities will focus on improving the hospital’s quality of care and making care delivery more efficient.

“We’ve worked extremely hard to achieve this recognition from Priority Health,” Williams said. “It’s a true blessing for Oaklawn and its patients that our efforts indeed have been noticed.”

The funds also will be directed in ways that are intended to improve patient care, said Jane Jones, Oaklawn’s executive director for organizational excellence. One way will be to expand and enhance utilization of the Cerner clinical information system among Oaklawn’s clinical staff.

“Improving access by our staff to electronic records translates into efficient and speedy patient service, particularly in emergencies,” Jones said.

In addition, the money also will be used to support additional training in the “lean” health-care program supervised at Oaklawn by consulting firm Breakthrough Horizons. That initiative identifies methods health-care providers can implement to use time and resources more effectively.

“Lean training looks at identifying waste, excess waiting time, excess resource utilization – and making sure our processes are efficient and effective,” Jones said. “It’s done to improve patient satisfaction by helping patients move through our system quicker, with the right care at the right time.”

The incentive payment came as the result of months of work by Oaklawn’s staff to meet standards set by the nonprofit, Michigan-based insurer, Jones said.

“What Priority Health does is set benchmarks for excellent performance standards,” she said. “Oaklawn submitted data that show that we perform at an excellent level of care.”

Those benchmarks focus on usage, quality, costs and member satisfaction, Jones said. Priority Health responds to the submitted data by rewarding performance that meets or exceeds the National “Top 10” threshold performance.

Those figures are established by the Centers for Medicare & Medicaid Services and its national hospital benchmarks, updated in October 2012 through Hospital Compare, a project of the U.S. government.

Priority Health’s representatives measure results and reward efforts that support prevention, improved clinical outcomes and the delivery of cost-effective care, Jones said.

The use of quality and efficiency-based incentive payments is part of the trend by Medicare and many commercial health plans toward value-based payments in a shift away from pure volume-based payment, as exemplified by fee-for-service payments, to payments that are more closely related to quality and outcomes.

Results for participating U.S. hospitals in the project can be accessed at www.medicare.gov/hospitalcompare. Information about quality, safety and satisfaction at Oaklawn Hospital is available online at qss.oaklawnhospital.org.