It seems that everything is happening at once and agencies are beginning to feel the pressure, more than ever, to keep up with it all and make sure they reach the marks needed to keep their doors open. Following is a recap of key dates and comments on highlights of things agencies should have at the forefront of their focus:

Pay for Reporting Performance Requirement

The first performance period run is 07/01/15 – 06/30/16 and the minimum compliance standard for this period is 70%. Agencies with compliance levels below 70% for this period will see a 2% reduction in their annual payment update for CY 2017.

There are seven OASIS Assessments that fit into the definition of a quality assessment that are monitored by this requirement. The full description of those assessments can be found at the link below:

Home Health Quality Reporting Requirements

CMS has released Quality Assessment ONLY (QAO) Historical Performance Reports to for agencies to compare historical data from July 2013 – June 2014. Using this information, agencies can determine how much work they have to do to get the numbers they need for 2015-2016. The reports can be downloaded by logging into your CASPER account and accessing the “Shared Folders”.

The Home Health 2016 Proposed Regulation includes standards for the next two years at 80% and 90% in order to not receive the 2% reduction in subsequent years.

Quality of Patient Care Star Ratings

Updates will be provided on a quarterly basis to the summary of 9 of the quality measures, based on OASIS patient assessments and Medicare claims data that will be published on Home Health Compare beginning July 16, 2015. Quality of Patient Care Star Rating Provider Preview Reports showing the calculation of the July 2015 star rating were distributed to providers 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 in 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

Home Health Compare Review Report

There have been two new measures added to the Home Health Compare reporting beginning July 2015. It is pretty obvious that these measures are being added due to the proposed Value Based Purchasing Pilot included in the proposed regulation for 2016. Following are the new measures:

  • 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)

Beginning in April 2015 the Home Health Compare reports have been issued on a quarterly vs. annual basis.

Value Based Purchasing Proposed Pilot

The proposed regulation for 2016 includes a Value Based Purchasing Pilot set to be implemented January 2016. Make sure to comment on the proposed regulation by September 4, 2105.

Hope this information will help in dealing with the overwhelming aspects of the past, present and future of quality monitoring.