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CMS Considers Changes to the Home Health QoPC Star Ratings

Posted on Tuesday, January 31, 2017 1:11 PM

In January, home health providers were informed that CMS is considering making two changes to the Home Health Quality of Patient Care (QoPC) Star Ratings based on stakeholder and Technical Expert Panel (TEP) feedback.

The following changes include:
• Remove measure: Influenza Immunization Received for Current Flu Season (based on OASIS data)
• Add measure: Emergency Department (ED) Use without Hospitalization (claims-based)

The rationale for removing influenza immunization received for current flu season was influenced by factors outside the home health agencies control and may vary by state. The measure would still be reported on Home Health Compare (HHC) to continue to encourage benefits of vaccination. The addition of ED use without hospitalization is thought to capture and reward agencies that are successful in lowering ED use among their patients. CMS highlights that the addition of this measure in the QoPC Star Rating would better reflect quality.

Recognizing the information posted on HHC and the current methodology for calculating and reporting the star ratings is crucial for home health agencies and other stakeholders to understand. Using the QoPC Star Ratings to see how you compare with your competitors can facilitate in strategically developing quality improvement initiatives in areas where you fall behind.

Corridor’s Coding and OASIS Review service line has improved agencies QoPC Star Ratings. Knowing where our agencies have potential for improvement and ensuring these OASIS items are scored accurately at SOC/ROC time points can make all the difference.

Many of the OASIS questions that comprise the star rating calculations have responses with very little activity or assessment finding differences, and clinicians need to support their OASIS answers with further narrative documentation. Avoid using radio-button drop-down selections without giving further description of the patient’s condition, especially at SOC, ROC and EOC OASIS assessment time points.

Your quality assurance team and/or third-party vendors can better support suggesting a change to an OASIS response and provide education to the clinician if supporting documentation surrounding the OASIS responses is provided.

Contact Corridor to learn how we can help improve your QoPC Star Ratings. In addition, if you have questions or comments on the changes to the star ratings being proposed, CMS is accepting comments from January 20th thru February 20th of 2017. For comments, visit HH_QM_Comments@abtassoc.com.

Written by Amanda Gartner, Corridor's OASIS Manager.

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