What is risk adjustment in home health?
Risk adjustment is a statistical process that incorporates the underlying health status of patients when looking at their health care outcomes. Note that the risk adjustment models used within the HHVBP Model are the same as the ones used for all HHAs (e.g., Home Health Compare).
What is a potentially avoidable event in home health?
Potentially Avoidable Event (PAE) measures are a subset of outcome measures. The potentially avoidable events reported are outcome measures, in the sense that they represent a change in health status between start or resumption of care and discharge or transfer to inpatient facility.
What is a CMS process measure?
CMS implements quality initiatives to assure quality health care for Medicare Beneficiaries through accountability and public disclosure. CMS uses quality measures in its various quality initiatives that include quality improvement, pay for reporting, and public reporting.
What is SOC for home health?
A Start of Care (SOC) or Resumption of Care (ROC) assessment that has a matching End of Care (EOC) assessment. EOC assessments are conducted at transfer to an inpatient facility (with or without discharge), death, or discharge from home health care. This is labeled as an “SOC/ROC Pseudo Episode” quality assessment.
What are CMS quality measures?
Quality measures are standards for measuring the performance of healthcare providers to care for patients and populations. Quality measures can identify important aspects of care like safety, effectiveness, timeliness, and fairness.
How many CMS measures are there?
686 CMS measures
Of the 686 CMS measures, 153 were selected and grouped into Key Indicators to track progress in measurement areas critical to providing high-quality care and improving outcomes.
How long should a home health visit last?
These services are provided for no more than eight hours per day. However, the average visit lasts about an hour or less. You may expect the nurse or therapist to check your temperature, blood pressure, heart rate, and breathing during a home health visit.
When it comes to home health documentation What is an oasis?
The Outcome and Assessment Information Set (OASIS) is the patient-specific, standardized assessment used in Medicare home health care to plan care, determine reimbursement, and measure quality.
What is a risk adjustment model in health care?
Risk Adjustment Model • Risk adjustment model means an actuarial tool used to predict health care costs based on the relative actuarial risk of enrollees in risk adjustment covered plans (45 CFR 153.20) • HHS is developing a risk adjustment model for the nonelderly population to be used when HHS is operating risk adjustment on
What are claims-based measures of home health outcomes?
Claims-based measures are a subset of home health outcome measures. We calculate them using Medicare fee-for-service (FFS) claims data. There are two types of claims-based measures: 1) claims-based utilization measures and 2) claims-based cost/resource use measures.
What quality measures are used in the Home Health Quality Reporting Program?
The following two categories of quality measures are used in the Home Health Quality Reporting Program (HH QRP): It is important to note that only a subset of process and outcome measures are HH QRP measures that have been finalized via rule-making and that are publicly reported on Care Compare.
How many measures are in the HHCAHPS on care compare?
CMS groups the measures by topic into three composite measures and two overall measures. CMS publicly reports the HHCAHPS on Care Compare (ZIP), and they are called “patient survey results” on the compare site.