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The Centers for Medicare and Medicaid Services (CMS) recently announced that corrections have been made to the hospice quality measure reports available in CASPER and are now ready for viewing.
CASPER – Certification And Survey Provider Enhanced Reporting – is the application used by CMS to share data with providers that has been submitted by providers through the Hospice Quality Reporting Program (HQRP). In other words, CASPER contains an individual hospice provider’s submitted HQRP data in the format of various useful reports, some comparing the hospice’s submitted data to that of other hospices in the state and the nation. Yes, Hospice Compare contains some of this information, but CASPER contains more data and the data is more current.
It has come to our attention that some hospices are not aware of these reports and are not accessing them and are missing out on valuable information. To get started with CASPER, a hospice must obtain two IDs and passwords. Instructions for applying for these passwords are found here.
Two of the reports in CASPER that are most useful to hospices are the Timelines Compliance Threshold Report and the Final Validation Report. The Timeliness Compliance Threshold Report lets a hospice know what percentage of its HIS submissions were timely. A hospice must submit 90% of its HIS-Admission and HIS-Discharge records within 30 days of the qualifying event (admission or discharge) in order to avoid the 2% annual payment update. The Final Validation Report lets a hospice know which of the HIS-Admission and HIS-Discharge records submitted were actually accepted by CMS. We are surprised at the number of hospices that thought they were successfully submitting records only to be surprised the following year when they received a letter from CMS indicating they were subject to the 2% annual payment update for not participating in the HQRP – all because they did not realize their submitted records were not actually received by CMS. If they would have viewed the Final Validation Report they would have seen that the records were not accepted. Likewise, there are times when CMS’ data shows the records were not received when, in actuality, they were. If a hospice has its Final Validation Reports as evidence that its records were accepted, the hospice can appeal the 2% penalty. However, the Final Validation Report is purged from the system after 60 days so we recommend hospice providers download or print these reports and save them.
Other important and helpful reports are available through CASPER, namely, the quality measure (QM) reports. These reports reveal a hospice’s performance on the quality measures captured from the HIS, i.e. Pain Screening, Dyspnea Treatment, Hospice Composite Measure. Two reports available for each measure allow the hospice to see its performance compared to other hospices nationally and also allows a deep dive into the quality measures at the patient level allowing the hospice to see which of the measures were triggered for each patient. This information can be used to improve performance and overall quality of care.
More HIS-related reports than were discussed here are available in CASPER and are updated regularly. Some Hospice CAHPS Survey-related reports are also available in CASPER. More information on CASPER and its resources can be found here.
Need help with HQRP or your Quality Assessment and Performance Improvement (QAPI) program? Schedule a call with us to find out how we can help!