Waits and Measures

There’s no question that accreditation can be a challenge for some HME providers. There are many business processes and procedures that providers now have to adopt in order to meet the requirements that CMS issued in its final quality standards, and all of the agency’s approved accreditors must ensure that you comply with these requirements.

While providers may have had organized business practices over the years, most wrestle with the requirements presented in the Performance Management section. This is an area that is often new and foreign.

In the Performance Management section, CMS requires that providers measure, at a minimum, five indicators. The first three are concrete and easily understood indicators that do not really present much of a challenge in creating a system to track and measure. These include customer satisfaction and complaints, frequency of billing and coding errors and the occurrence of adverse events.

But the remaining two are tougher for a provider to measure. They are: timeliness of response to beneficiary question(s), problem(s) and concern(s); and impact of supplier’s business practices on the adequacy of beneficiary access to equipment, item(s), service(s) and information.

Let’s addresses them individually.

• Timeliness of response to beneficiary question(s), problem(s) and concern(s). How would you measure the timeliness of your response to customers during business hours? That sounds rather unmanageable. Most likely, you and your staff respond appropriately to customers as they ask questions or need help, and it might be hard to measure your response time to determine if it is “timely” during business hours. But, if you provide respiratory services, you are required to provide after-hours services, so tracking the timeliness of response to these calls would be logical. If you provide after-hours services, you use a log to document and track all after-hours calls and how timely your staff returns those calls and services those customers. For everyone else, however, it may not be so easy. Additionally, the expectation is that you measure an indicator with the goal of making improvements. Here are some suggestions to consider:
  • If you are a medium-to-large provider, can you measure how long customers are on hold on the telephone? Do you use (or could you install) call management software to track numbers of calls, how long callers wait on hold, etc? Other than the obvious staff management benefits these types of packages provide, this would allow you to track wait times and easily work toward solutions to reduce this wait time.
  • Whether or not you are a small supplier, how often do you have to special order items for customers? When you do, you could track what the item is and how long it takes for the item(s) to arrive. This can help you with strategic planning to see if there are items or supplies that you might stock more of. Or you might decide to look for alternative vendors that can get an item to you in a more timely manner.
  • If you are a pharmacy, how often do you have to provide a “partial fill” for a prescription? Could tracking this data assist you in better ordering for particular customers or to accommodate seasonal concerns?

• Impact of supplier’s business practices on the adequacy of beneficiary access to equipment, item(s), service(s) and information. This indicator is useful for several reasons. By tracking and measuring how your customers are able to receive services, you can learn if there are products or services your company could offer in addition to those you already provide, as well as learning how beneficiaries are accessing their benefits.

You are already required to assess customer satisfaction, so be sure to include a question or two that accomplishes this requirement. Also, make sure that your surveys ask for a measurable response, not a yes or no answer. Your surveys should always offer your customers a chance to respond with a “scaled” answer such as:

On a scale of 1 to 5, with 1 being “Poor” and 5 being “Excellent,” please rate the following statements.

Thus, if you get responses below a “5” on any question, you have the opportunity for improvement. In a “yes/no” scenario, you don’t have a much of an option other than changing “no’s” to “yes’s.”

The questions on your customer satisfaction survey that would accomplish the requirement to track this indicator might include:

• Were you able to get everything you needed from us today?
• Are you aware of all of the products and services we offer?
• How would you rate our business practices with the customer service we provide and the products we offer?

These questions evaluate (assess the impact) whether or not the products and services you (the supplier) offer (your business practices) meet the customer’s needs (adequacy of beneficiary access).

Remember, when gathering your data, you don’t need to focus on your Medicare customers. Accreditation requires that you standardize your services for all customers, regardless of their payer. You want to assess the satisfaction of all of your customers, not just your Medicare customers.

It is much easier to implement surveys and track indicators throughout your operation instead of trying to focus only on Medicare customers. Make sure you are not tracking indicators just to meet the CMS requirements, but to learn about your business and make improvements when possible.

Mary Ellen Conway, RN, BSN, is president of Capital Healthcare Group, LLC, Bethesda, Md., which provides health care management expertise in accreditation preparation and survey follow-up, operations assistance, design of quality improvement programs and outcome measures. You can reach her at 301/896-0193 or through www.capitalhealthcaregroup.com.