Home Health & Hospice Week

You’ll need to monitor hospital-discharged patients more closely than ever.

 If you think Medicare already is holding you accountable for circumstances outside your control with hospitalization quality measures, that problem is about to intensify.

The Centers for Medicare & Medicaid Services wants to add two new quality measures for home health agencies — "Rehospitalization during the first 30 days of HH" and "Emergency Department Use without Hospital Readmission during the first 30 days of HH." CMS would apply the measures to patients who had an acute inpatient hospitalization in the five days before the start of a HH stay. CMS would base both measures on claims, not self-reported data, it says in the home health prospective payment system proposed rule published in the July 3 Federal Register.

Recently hospitalized patients are at an increased risk of hospital use, CMS notes in the rule. "Addressing unplanned hospital readmissions is a high priority for HHS as our focus continues on promoting patient safety, eliminating healthcare associated infections, improving care transitions, and reducing the cost of healthcare," the agency says. "Rates of rehospitalization remain substantial with 14.4 percent of HH patients experiencing an unplanned rehospitalization in the first 30 days of care."

CMS will continue to publicly report agencies’ current ACH and ED measures. "These measures apply to all home health patients and will continue to be useful in selecting a home health agency," the agency says. "The proposed rehospitalization measures will allow HHAs to further target patients who entered HH after a hospitalization."

Agencies would begin receiving their new measure data in 2014 and CMS would add the measures to Home Health Compare for public reporting in 2015, explains the Visiting Nurse Associations of America in a summary of the rule.

Meanwhile: CMS proposes to remove some of the OASIS-based process measures HHAs receive in their CASPER reports. For nine CASPER measures, CMS wants to report data only for all episodes of care. Currently, agencies receive data on short-term and long-term episodes as well.