Chasing Quality Clarity in Home Care

Hospice quality benchmarks have evolved with new goals and initiatives, and even penalties in reimbursement.

Measuring quality and satisfaction was pretty ambiguous for home care and hospice until developments in the last ten years. Since then multiple changes have taken place to increase the visibility of care provided by hospice and home care agencies, as well as long-term care and skilled nursing facilities.

“CMS implemented the HCAHPS survey in October 2006, and the first public reporting of HCAHPS results occurred in March 2008.”

Hospice quality benchmarks have evolved with goals and initiatives, and even penalties in reimbursement, with more to come from what it seems.

“Effective with the FY 2022 Final Rule, beginning with the FY 2024 APU and for each subsequent year, the APU penalty is increased from 2% to 4% for hospices that do not comply with the HQRP for that FY.”

Here are some of the most recent and some upcoming changes…

  • Non-medical homecare providers in many states have been required to implement quality management programs.

  • Hospice quality scores are now published nationally with a star rating, just like nursing facilities on the Medicare Care Compare website.

  • Two claims-based measures, the HDVL and HCI. Hospice Visits in the Last Days of Life (HVLDL) (NQF #3645) and the Hospice Care Index (HCI) have been added.

  • HDVL and HCI include capturing live discharges, “burdensome transitions” and HVLDL correlates directly with SIA (Service Intensity Add-On) payments.

  • The new quality measurement assessment tool, still in development, “HOPE” which stands for “Hospice Outcomes and Patient Evaluation” will eventually replace the Hospice Item Set (HIS) currently used to assess hospice processes for obtaining quality indicators.

Many new agencies struggle to get programs in place that consistently meet the changing requirements for quality management and improvement.

The purpose of this blog is to provide newly established and growing homecare and hospice organizations and their leaders with practical insights and resources for quality management and improvement and regulatory compliance and accreditation toward the ultimate goal of contributing to providers achieving excellence in every area of operations.

Categories: : Operational Excellence