Frequently Asked Question of the Month:
What types of quality measures are used in the Home Health Quality Reporting Program?
The following three categories of quality measures are used in the Home Health Quality Reporting Program (HH QRP):
- Outcome measures
- Process measures; and
- Patient reported outcome measures
Questions about home health quality measures may be sent to HomeHealthQualityQuestions@cms.hhs.gov.
Spotlight on: Outcome Measures
Outcome measures assess the results of health care that are experienced by patients. The data for the Home Health outcome measures are derived from 2 sources: (1) data collected in the Outcome and Assessment Information Set (OASIS) submitted by home health agencies; and (2) data submitted in Medicare claims.
Measures based on OASIS data are calculated using a completed quality episode of care that begins with the home health agency start of care (or a resumption of care following an inpatient facility stay) and ends with discharge, transfer to inpatient facility or, in some cases, death. Some outcome measures are based on claims data.
Many home health outcome measures are risk-adjusted. Risk-adjusted outcome measures are identified in the Home Health Outcome Measures Table. The risk adjustment methodology, using a predictive model developed specifically for each measure, compensates for differences in the patient population served by different home health agencies.
The HH QRP measures and the broader list in the Home Health Quality Initiative, include four types of Outcome measures:
- Improvement measures (i.e., measures describing a patient’s ability to get around, perform activities of daily living, and general health),
- Measures of potentially avoidable events (i.e., markers for potential problems in care),
- Utilization of care measures (i.e., measures describing how often patients access other health care resources either while home health care is in progress or after home health care is completed), and
- Cost/Resource measures
For a list of home health outcome measures, please refer to the Home Health Outcome Measures Table on the CMS website – https://www.cms.gov/medicare/quality/home-health/home-health-quality-measures. Technical Specifications for calculating outcome measures, patient-related characteristics measures, and the factors used to risk adjust outcome measures, can be accessed via the link for Home Health Quality Reporting Program (HHQRP) Quality Measure (QM) User’s Manual.
Symbria is committed to maintaining a high standard and level of communication with our clients and employees regarding clinical education, PDGM understanding, patient assessment, home health regulations, and coding efficiency. As a result, the Home Health Insider was born. In this monthly offering, we hope to provide some valuable information that can foster a quality level of care that meets the needs of the patients that we serve.