Home Health & Hospice Week

Will you be one of the 16 percent of agencies with lower ratings?

You may not like the flu vaccination component of your Home Health Compare star rating, but will a new factor on Emergency Department use be any better?

That’s what you’ll find out if the Centers for Medicare & Medicaid Services finalizes its plan to eliminate “Influenza Immunization Received for Current Flu Season (based on assessment data from OASIS)” from the nine measures used in the star rating calculation and replace it with “Emergency Department (ED) Use without Hospitalization (claims-based).”

CMS outlined its plans to change the methodology in a Jan. 19 Special Open Door Forum. The agency is contemplating removing the flu vaccination item from the calculation because it is influenced by factors outside the HHA’s control that may vary by state, it said.

However, the measure wouldn’t entirely go away. Home Health Compare will continue to display the individual measure “to continue to encourage vaccination,” CMS pointed out in the call.

CMS is considering adopting the ED use measure because it will reward agencies that are lowering their patients’ ED usage and it better reflects quality of care, the agency maintained.

Impact: CMS estimated that the change will decrease the number of HHAs with available quality of patient care star ratings by 25 HHAs. And while the average QoPC star rating would stay the same at 3.24 stars, 67 percent of HHAs would have the same rating, 17.5 percent of agencies’ ratings would increase by half a star, and 15.8 percent of agencies’ ratings would decrease by half a star, according to the agency.

CMS also predicted that the change would boost ratings for small HHAs (those with fewer than 250 episodes per year). However, it would also boost ratings for agencies with a larger proportion of long-stay patients (agencies with more than 40 percent of episodes longer than 90 days).

Take action: You can give CMS and its contractor Abt Associates your two cents on the changes by submitting comments to HH_QM_Comment@abtassoc.com by Feb. 20. CMS plans to hold an Open Door Forum on the topic March 17.

CMS plans to move ahead quickly with the change, if it’s adopted. Agencies’ April QoPC preview reports could contain the new calculation, the agency said.

Resource: See the forum slides at www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2017-01-19-HHQoPC-Presentation.pdf.