CMS Posts Several Home Health Updates

Yesterday the Centers for Medicare and Medicaid Services (CMS) posted six home health updates:

 

1. Home Health Quality Reporting – QAO Historical Performance Reports Distributed

Please note, July 1 marked the beginning of the first 12-month performance period for the new “Quality Assessment Only” (QAO) metric that will be used to assess providers’ compliance with the new “Pay-for-Reporting Performance Requirement” established in the CY2015 Home Health Final Rule. According to CMS, this first performance period runs from July 1, 2015 through June 30, 2016 and the minimum compliance standard for this period is 70%. 

HHAs with compliance levels below 70% for this period will see a two percentage point reduction in their annual payment update (APU) for calendar year (CY) 2017. 

CMS has distributed informational QAO Historical Performance Reports to providers’ CASPER Shared folders.  These reports show the calculation of the QAO metric based on the provider’s OASIS submissions during the period July 2013 – June 2014.  These reports are purely informational and will have no impact on providers’ payments. They will be available in the CASPER folders for 120 days, or until October 26, 2015.  Providers having problems accessing their CASPER folder can consult the section on “Shared Folders” in the CASPER Reporting Provider User Guide or contact the QTSO Help Desk by telephone at 800-339-9313 or by e-mail to: help@qtso.com

Additional information on the QAO metric and the Historical Performance Reports is available on the Home Health Quality Reporting web page.

2. Quality of Patient Care Star Ratings to be Posted on Home Health Compare in July and Provider Preview Reports for October Distributed

The Quality of Patient Care Star Ratings, a summary of 9 of the quality measures based on OASIS patient assessments and Medicare claims data, will be published on Home Health Compare beginning July 16, 2015, and will be updated on a quarterly basis.  Quality of Patient Care Star Rating Provider Preview Reports showing the calculation of the July 2015 star rating were distributed to providers (via their CASPER folders on the QIES system) at the beginning of April.  The second round of Quality of Patient Care Star Rating Provider Preview Reports, showing the calculation of the star rating to be published in October 2015, have also been distributed to providers’ CASPER shared folders. They will be available in the CASPER folders for 120 days, or until October 26, 2015.  Providers can request review of the Quality of Patient Care Star Rating by CMS if they can document the presence of data problems that affect the final star rating and submit a plan of correction. The deadline for submitting these requests is July 17, 2015; instructions for submitting these requests are included on page 3 of the preview reports.  More information on the Quality of Patient Care Star Rating and the provider preview reports is posted on the Home Health Star Ratings web page.

Note that the Patient Survey Star Ratings, based on the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey data are not scheduled for publication on Home Health Compare until January 2016.  Information about the Patient Survey Star Ratings is available on the HHCAHPS web page. Questions about the HHCAHPS Patient Survey Star Ratings can be submitted to: HHCAHPS@RTI.org.

As a reminder LeadingAge members can preview their star ratings now. LeadingAge has Home Health Quality Metrics, which analyzes quality metrics in categories such as Managing Daily Activities, Managing Pain and Treating Symptoms, Treating Wounds and Preventing Pressure Sores, Preventing Harm, Preventing Unplanned Hospital Care and Patient Satisfaction Survey results using the most current publicly reported Home Health Compare data.

Please note on Wed., Aug. 5, 2015 11:00 AM - 12:00 PM EDT LeadingAge NY will conduct a webinar on Home Health Quality Metrics, to sign-up please click here.

3. Home Health Compare Provider Preview Reports Published Quarterly.

As of April 1, 2015, Home Health Agencies began to receive Home Health Compare Provider Preview Reports for all process measures and outcome measures on a quarterly, rather than annual, basis. The second quarterly report has just been distributed to providers’ CASPER shared folders.

4. Two new measures to be posted on Home Health Compare. 

Beginning in July 2015, two new NQF-endorsed quality measures will be added to HHC:

• Rehospitalization During the First 30 Days of Home Health (NQF #2380)
• Emergency Department Use without Hospital Readmission During the First 30 Days of Home Health (NQF #2505)

These measures were added to the CASPER reports in January 2014 and were originally scheduled to be published in 2014, but were deferred to coincide with other updates to HHC taking place in July 2015. Technical documentation on these measures and their risk adjustment models is available here.

5. Final OASIS-C1 Dataset and Manuals Posted

CMS recently received OMB clearance for the OASIS-C1/ICD-10 data set; the final data set; as well as the final OASIS-C1/ICD-10 Guidance Manual to be posted on the Home Health Quality Initiative web pages.

The data set has been posted on the OASIS-C1 Data Sets page.

The manual is on the OASIS User Manuals page.

6. Single Helpdesk for Home Health Quality Questions.

Questions about home health quality measures, home health pay-for-reporting and the QAO metric, home health Quality of Patient Care Star Ratings and star rating preview reports can all be submitted to HomeHealthQualityQuestions@cms.hhs.gov.

7. Reminder – Open Door Forums (ODF) are Recorded

On July 8, CMS hosted an Open Door Forum (ODF). The agenda included updates and discussion on:

• home health and hospice proposed rule;
• home health CAHPS survey news;
• home health star rating materials;
• hospice announcements;
• home health claims processing announcement;
• accessing HHAs CASPER reports;
• home health quality questions mailbox; and
• publication of the OMB-approved OASIS-C1/ICD-10 data set and final OASIS-C1/ICD-10 manuals.

If you couldn’t participate on July 8, the ODFs are recorded and available for two days after the event.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871