How quality leaders are rethinking patient prioritization for CMS, HRRP and VBP

Monday, June 1st, 2026 | 1:00 PM - 2:00 PM CT

Many hospitals still rely on generic clinical risk scores to flag high-risk patients. The challenge: those scores aren't built to map to how CMS Star Ratings, HRRP, VBP and Leapfrog measure performance — which means quality improvement effort can be deployed without proportionate impact on the programs that drive reimbursement and public reporting.

Quality outcomes aren't influenced equally across high-risk patients. Specific patient scenarios — EDAC-relevant cohorts, patients admitted via SNF, palliative concerns — carry a disproportionate impact on readmissions, mortality and overall program performance. Without a way to flag those patients up front, hospitals can work against the measure rather than directly on it.

This session outlines how hospitals can design and apply goal-based patient priority scores aligned to specific program goals and built to complement traditional clinical risk models, not replace them.
 

Learnings include:

• How patient-level prioritization can be aligned with CMS Star Ratings, HRRP, VBP and Leapfrog measures
  
• Why specific patient scenarios disproportionately influence quality outcomes
  
• Examples of point-based scoring frameworks and priority bands
  
• How priority scores can guide improvement across ED, inpatient and discharge workflows

Feel free to register even if you can't attend live, we'll make sure to send you the recording afterwards. Hope to see you there!

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