Additional New Quality Measures for Home Health & Hospice Beginning in 2015

By: Visiting Nurse Associations of America on 12/16/2014

A number of new quality measures impacting home health and hospice providers are slated to begin in January 2015: The home health re-hospitalization measures and hospice participation in the Consumer Assessment Healthcare Providers and Systems (CAHPS) survey.

The home health re-hospitalization measures evaluate the outcomes of re-hospitalization and emergency department use without readmission for home health patients who were recently discharged from the hospital. These measures are claims-based re-hospitalization and ED use without hospital readmission during the first 30-days of home health. These measures include home health stays beginning within 5 days of an inpatient hospital discharge. For each measure data has been collected over the last year beginning January 2014. Home health agencies can expect to see these new measures reported in the January 2015 Home Health Compare update.

Hospices will begin to participate in the Consumer Assessment Healthcare Providers and Systems (CAHPS) survey in 2015. This new survey considers the hospice patient and his or her primary informal caregiver as the unit of care. The Hospice CAHPS Survey Instrument (mail and telephone) was approved by OMB in early December 2014. This survey is currently a “pay-for-reporting” program, which means that the submission of required data by specified deadlines determines compliance. Data submission requirements include the following:
 

  • Hospices must contract with a CMS approved survey vendor who will collect and submit the data on the hospice’s behalf
  • Hospices are required to participate in a dry run for at least one month in the first quarter of 2015 (January or February or March)
  • Hospices are required to participate on a continuous monthly basis starting April 2015
  • This means that for 2015, hospices are required to submit a minimum of 10 months of data to the CAHPS Hospice Survey Data Warehouse. This includes one month during the dry run and monthly for all nine months April through December 2015. (Hospices who participated for more than one month during the dry run may submit all months to the CAHPS Hospice Survey Data Warehouse.)
  • In subsequent years continuous monthly participation is required
  • Hospices that fail to meet the CAHPS Hospice Survey requirements as specified in rulemaking will receive a two percentage point reduction in their APU
  • The participation requirements for CY 2015 will affect the 2017 APU. Participation requirements for subsequent years will impact subsequent APUs. For additional details, please click here