By Jennifer Gross, BSN, RAC-CT
Product Marketing Manager
Staying competitive and relevant in the world of healthcare is a constant battle as the landscape is always changing. One of the biggest shake-ups in the past few years is the way treatment is reimbursed with a shift from the traditional fee-for-service model to value-based payment. In response, many healthcare organizations are navigating the new waters and finding success through partnership and collaboration.

Why is this important? By studying the fruits of these partnerships, healthcare organizations can not only find new ways to stay competitive, but they can dramatically improve patient care and drive better patient outcomes.
One of the most recent examples of partnerships driving results comes from the state of New Mexico. The New Mexico Human Services Department (HSD), the New Mexico Health Care Association (NMHCA), nursing home provider leadership, and the state’s three Medicaid managed care organizations (MCOs) formed a collective workgroup to tackle the new challenges together. Forming the New Mexico Nursing Facility Value Based Payment (NF VBP) Workgroup, a review of the collaboration shows us how properly leveraged data, communication, and transparency can effectively drive improved patient care and better patient outcomes.
The Challenge Overview
The NF VBP knew it was facing a unique set of shared challenges including an aging population with complex needs, logistical challenges from geographically dispersed facilities, and data collection hurdles making it hard to effectively benchmark, foster growth, and meet the demands mandated by the Centers for Medicare and Medicaid Services (CMS). Failure to meet these challenges can spell trouble, especially in a highly competitive industry where the competition also understands the importance of innovation.

A Solution in Plain Sight
Sometimes identifying a solution and achieving a solution are two totally different beasts. The NF VBP knew the solution to their challenges was data. By finding a way to collect meaningful data in near real-time, the workgroup would be better equipped to make the necessary changes, deploy the right new processes, and respond to the ever-changing healthcare landscape better and faster.
However, the solution wasn’t that simple. Because of things like the complexity of each of the workgroup member’s operations, the challenges of the MDS workflow, and concerns of new burdens on staff, finding a streamlined solution seemed like an impossible task.
A Second Partnership
Luckily, a solution existed to not only meet, but exceed the high demands of the NF VBP workgroup. PointRight®, a Net Health company, delivered an advanced analytics solution that offered all the necessary data the group needed in near real-time, and in a way that easily integrated with existing systems and didn’t bring additional burdens on staff.
The results? Transparency, an improved patient experience, and satisfied customers. With the ability to facilitate care coordination from the top-down, collect and aggregate data by facility, corporation, and MCO, identify and meet unique quality measures, and so much more, the NF VBP has established itself in a strong position to meet and exceed the challenges of today and the future.
New Mexico Nursing Facility VBP Case Study
If you’d like to learn more details, we’d invite you to check out a free copy of the complete case study titled—New Mexico Nursing Facility Value Based Payment (NF VBP) Workgroup Partners with PointRight® to Improve Patient Care and Outcomes.
About the Author

Jennifer Gross, BSN, RAC-CT
Product Marketing Manager
Jennifer Gross’s experience in the nursing field includes work in psychiatric rehab and in long term care as a staff nurse, MDS coordinator, and as a consultant. Her role at PointRight is to support our clients in understanding the intricacies of the MDS, enabling them to maximize quality of care, identify residents at risk, and prevent decline.