Home Health & Hospice Week
Hone These 29 Measures To Succeed Under VBP
Would your scores on these measures put you in the prize or penalty pool?
Home health agencies may not be happy about some of the measures the Centers for Medicare & Medicaid Services is proposing for inclusion in the Value-Based Purchasing pilot program. But they’d better get to work on improving them as fast as they can.
According to the home health prospective payment system proposed rule released July 6, HHAs in the nine pilot states will be graded — on both achievement and performance — based on these outcomes:
Outcome Measures
1. Improvement in Ambulation-Locomotion, Data Source: OASIS (M1860)
2. Improvement in Bed Transferring, Data Source: OASIS (M1850)
3. Improvement in Bathing, Data Source: OASIS (M1830)
4. Improvement in Dyspnea, Data Source: OASIS (M1400)
5. Discharged to Community, Data Source: OASIS (M2420)
6. Acute Care Hospitalization: Unplanned Hospitalization during first 60 days of Home Health; Hospitalization during first 30 days of Home Health, Data Source: Claims
7. Emergency Department Use without Hospitalization, Data Source: Claims
8. Improvement in Pain Interfering with Activity, Data Source: OASIS (M1242)
9. Improvement in Management of Oral Medications, Data Source: OASIS (M2020)
10. Prior Functioning ADL/IADL, Data Source: OASIS (M1900)
11. Care of Patients, Data Source: CAHPS
12. Communications between Providers and Patients, Data Source: CAHPS
13. Specific Care Issues, Data Source: CAHPS
14. Overall rating of home health care, Data Source: CAHPS
15. Willingness to recommend the agency, Data Source: CAHPS
Process Measures
16. Timely Initiation of Care, Data Source: OASIS (M0102; M0030)
17. Care Management: Types and Sources of Assistance, Data Source: OASIS (M2102)
18. Pressure Ulcer Prevention and Care, Data Source: OASIS (M1300; M2400)
19. Multifactor Fall Risk Assessment Conducted for All Patients who Can Ambulate, Data Source: OASIS (M1910)
20. Depression Assessment Conducted, Data Source: OASIS (M1730)
21. Influenza Vaccine Data Collection Period: Does this episode of care include any dates on or between October 1 and March 31?, Data Source: OASIS (M1041)
22. Influenza Immunization Received for Current Flu Season, Data Source: OASIS (M1046)
23. Pneumococcal Polysaccharide Vaccine Ever Received, Data Source: OASIS (M1051)
24. Reason Pneumococcal vaccine not received, Data Source: OASIS (M1056)
25. Drug Education on All Medications Provided to Patient/Caregiver during all Episodes of Care, Data Source: OASIS (M2015)
New Measures
26. Adverse Event for Improper Medication Administration and/or Side Effects, Data Source: Reported via new HHVBP Web portal
27. Influenza Vaccination Coverage for Home Health Care Personnel, Data Source: Reported via new HHVBP Web portal
28. Herpes zoster (Shingles) vaccination: Has the patient ever received the shingles vaccination?, Data Source: Reported via new HHVBP Web portal
29. Advanced Care Plan, Data Source: Reported via new HHVBP Web portal
Only Pilot-State Agencies Must Report New Measures
You’ll be exempt from the four new measures — at least for now — if you aren’t in a VBP state. “All Medicare-certified HHAs in selected states, regardless of cohort size or number of episodes, will be required to submit data on the New Measures for all Medicare beneficiaries to whom they provide home health services within the state (unless an exception applies),” CMS explains in the rule. “Competing Medicare-certified HHAs would submit data through a dedicated HHVBP web-based platform.”
Reporting-only: “For those HHAs with a sufficient number of episodes of care to be subject to a payment adjustment, New Measures scores included in the final TPS for PY1 are only based on whether the HHA has submitted data to the HHVBP web-based platform or not,” CMS adds.
Note: More details about each measure is in Figure 4a of the rule at https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-16790.pdf.
Home Health & Hospice Week
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