Home Health & Hospice Week

Which measures count for what is an important factor.

One of the most important decisions you’ll make during the launch period of nationwide Home Health Value-Based Purchasing is which areas you’ll target for improvement. Heed this expert advice on how to ace that step.

Expanded HHVBP “is inclusive of a wide variety of patient information, but it seems they have made it more complicated that it has to be,” laments Julianne Haydel with Haydel Consulting Services and The Coders in Baton Rouge, Louisiana.

You can cut through some of that complexity by identifying areas for your improvement efforts and zeroing in on them.

After securing their data, home health agencies should “determine which areas they are not doing well in,” advises consultant Pam Warmack with Clinic Connections in Ruston, Louisiana. You may already have a good feel for this based on Care Compare, anecdotal sources, and more, or your data might surprise you.

“Get focused on … specific opportunities for improvement based on currently available data,” agrees reimbursement expert M. Aaron Little with BKD in Springfield, Missouri.

Keep in mind which measures count for the most under the new payment model, offers Sherri Parson with McBee.

And when looking at your stats, remember CMS will be comparing you not just to your local or state peers, but to those nationwide, reminds attorney Robert Markette Jr. with Hall Render in Indianapolis.

The OASIS-based and CAHPS-based categories have five measures each that count for 35 percent and 30 percent of an agency’s Total Performance Score under VBP, respectively, noted Elaine Gardner from Centers for Medicare & Medicaid Services contractor OASIS Answers Inc. in CMS’ “HHVBP Model Expansion 101” webinar in February. The claims-based category, however, has only two measures that make up 35 percent of the TPS — Acute Care Hospitalization and Emergency Department Use Without Hospitalization.

“Since Acute Hospitalization is the larger-scoring item towards an agency’s Total Performance Score, this would have a big benefit for agencies if they could lower their hospitalization rates,” Parson points out. However, ACH is also influenced by many factors over which an HHA has little to no control and can be hard to influence, observers point out.

“Start working on those areas that offer the best opportunities to improve or sustain, if applicable,” Little recommends.

Bottom line: “Agencies need to start figuring out now where to find their 2019 and current data in order to get an idea of where they might be standing,” advises consultant Angela Huff, also with BKD. “They need to know where to invest their efforts to make the biggest impact and get the ‘most juice for their squeeze,’” Huff tells AAPC.

Once you have identified your worst-scoring areas, you’ll need to strategize about “how to begin changing that now,” Warmack notes. That will include how “day-to-day processes need to be modified to meet the challenges,” she highlights.

“Success is possible using all of the management tools we have,” encourages consultant Linda Scott of Scott Solutions in Arlington, Virginia. Those tools include “defining goals, providing lots of training and support, monitoring and supervision, course correction and continuous improvement,” Scott tells AAPC.

Focus areas for improvement are likely to be OASIS data accuracy, patient experience-focused processes, as well as content-specific items for the areas agencies want to improve in, Scott expects.

Many agencies will be building on their already existing Quality Assurance and Performance Improvement (QAPI) plans, Scott notes. “Agencies who have pretty well developed QAPI programs already have some required strategies in place,” she says. Now they’ll need to “add as needed to your QAPI initiatives for measure, manage and improve,” she advises.

“We have been collecting and using OASIS data for more than 22 years now, and HHCAHPS is 12 years old,” Scott observes. “QAPI became a condition of participation four years ago. The red carpet has been laid out for this move for years now,” she concludes.