Hello, everyone and welcome to our Monday Minute. Today I’d like to discuss with you the HHCAHPS Requirements and how that impacts the Value-Based Purchasing  Rollout that will begin January 1, 2023.

As we discussed in the last Monday Minute, the Value-Based Purchasing Rollout that will begin January, 2023 will include a component where five categories of questions from HHCAHPS will be used to calculate the CAHPS portion of your Total Performance Score. One of the things that you need to ensure you understand is that the HHCAHPS data year runs from April 1 through March 31 of the following year.

When we discussed Value-Based Purchasing, we discussed the fact that there will be two cohorts, a large cohort and a small cohort, the small cohort consisting of all agencies in the nation that are not required to participate in HHCAHPS. The HHCAHPS requirement includes that if you have seen at least 60 patients in the previous year, you are required to participate in HHCAHPS. If you have not seen that many patients, then you can request an exemption from participating in HHCAHPS in the current year. The reality is that you have until March 31,  2022, to file that exemption request in order to be exempted from participating April 1 through March 31 of 2023. If you are exempted from participation, you will be in the small cohort in the calculations of the Value-Based Purchasing Total Performance Score.

So another couple of things that I wanted to mention about HHCAHPS and its involvement with the Value-Based Purchasing model. While there are five categories of questions, there are very specific questions from the 40+ questions that are on that questionnaire that go into this calculation of the Total Performance Score. We will include a list of those questions with this Minute today.

The thing I want to encourage you in is making sure that your clinical staff that see patients and when I say clinical staff, I really should say, field staff, because your aides are as important, in this process of HHCAHPS, as your nurses and therapists. All field staff, that are going to see a patient in their home, need to understand the HHCAHPS questionnaire, all of the questions that are included on that questionnaire, and how they personally can impact the response that your patients will provide when they take those HHCAHPS surveys. The surveys, I know many of you believe and feel just like I do, that they’re completely overwhelming that they’re too long, that they really are not something we want to do or participate in, but the reality is you’re required to do so if you’re a Medicare certified agency.

And so one of the suggestions I have for you is making sure that you have in-services with your field staff where you review the content of that questionnaire and again, discuss how your field staff can impact the responses that the patient provides to that questionnaire.  Obviously, you cannot read the questions to the patient. You cannot give them the questions. You cannot say to them, a survey will be coming in the mail and we expect that you’re going to give us a great rating. You can’t say things like that you can’t lead them, you can’t give them the exact questions, but the reality is there are some key questions or key words (let’s say that) within those questions, that if you’re using those words, when you are communicating with that patient, it’s going to help the patient realize and understand when they read the questionnaire, what exactly that questionnaire is and are going to be able to tie it to the conversations they’ve had with your staff, etc.

One example of that is one of the questions asked when you contacted the agency for help, did they respond in a timely manner? So most of the time, your patients are not going to call you and ask or say,  “I need help”. They’re going to call you because this is happening or that’s happening or this is happening. One of the agencies that we worked with during the Value-Based Purchasing demonstration, developed a business card size document or card that they gave to their patients upon admission and intermittently throughout their care, that said, “if you were to need HELP of any kind before your next visit, call this number”.  And so by saying that it’s going to get in their minds, the reality that each time they call, that is considered that they are calling you for help.

While some of this may sound very elementary, the reality is, when these elderly patients or their caregivers are reading these questionnaires, if the things that are asked in that questionnaire cannot be tied to communication or treatment that you’ve provided, then the response is going to be negative, it’s not going to be positive. And if your field staff have not been educated in the content of that questionnaire, there is no way that you can hope that they can positively impact the responses that you receive to those surveys.

I hope this has helped a little bit or at least if nothing else, inspired you to make sure that you’re reviewing the content of that document with your field staff so that they understand what questions the patients are even being asked.

We want to thank you all for participating today, for being a part of the nationwide effort in making sure that all of our patients are taken care of and taken care of to the best of our abilities, during this continuing Public Health Emergency. We appreciate your participation today and we hope to see you soon at a live state or national association conference near you.