January 31- Deadline for Submission of Structural Measure Data for Hospice

Reminder:   The deadline for attestation and submission of structural measure data for the Hospice Quality Reporting Program (HQRP) is Thursday, January 31, 2013.

Hospice providers that have not already created a user account and begun structural measure data entry should do so immediately. The link to the data entry site is available on the Data Submission portion of the HQRP website at the bottom of the webpage under “Related Links.” For step-by-step guidance on account creation, account activation, data entry and data submission, refer to the Technical User’s Guide for Hospice Quality Reporting Data Entry and Submission

For any questions about using the Hospice Quality Reporting Data Entry and Submission Site  contact the QIES Technical Support Office Help-desk by phone at 1-877-201-4721 or email at help@qtso.com

Technical Help-Desk hours are 8:00 a.m. through 8:00 p.m. ET.

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New Claims-based Measures for Hospitalization and ED Use

As reported in the Final Rule for CY 2013, there are significant changes in how the home health hospitalization rates are calculated. On January 17, 2013, the hospitalization measures based on these new calculations were posted on Home Health Compare.  Specifically, the Acute Care Hospitalization (ACH) and Emergency Department (ED) Use Without Hospitalization are now based on Medicare claims-based data rather than on OASIS-based data.

Key points to note:

  • Claims-based measure is based on the Start of Care (SOC) date instead of the transfer/discharge date.
  • Numerator:  the number of home health stays for patients who have a Medicare claim for an admission to an acute care hospital or for an emergency department visit in the 60 days following the start of the home health stay.
  • Exclusions from the Measure Numerator
    • Planned hospitalizations are excluded from the acute care hospitalization claims-based measure numerator.
  • Observation stays that begin in a hospital emergency department but do not result in an inpatient stay within the 60 days after the start of home health care are counted in the ED Use without Hospitalization measure.
  • Observation stays that result in an inpatient stay within the 60 days after the start of home health care are counted in the Acute Care Hospitalization measure even if the patient is discharged from the home health agency.
  • Denominator:  the number of home health stays that began during the reporting period.
  • Exclusions from the Measure Denominator
    •  Home health stays for patients who are not continuously enrolled in fee-for-service Medicare during the 60 days following the start of home health stay. (Medicare lacks full information about the patients utilization of health care services and cannot determine if care was sought in an ED during the numerator window,  60 days time period)
    • LUPAs are excluded from claims-based measure
    • Home health stays in which the patient receives service from multiple agencies during the first 60 days are excluded from the denominator.
    • Home health stays for patients who are not continuously enrolled in fee-for-service Medicare for six months prior to the start of the home health stay. (This is excluded because Medicare lacks information about the patient’s health status that is needed for risk adjustment)
  • There is significant difference in the claims-data and the OASIS-data for the ACH measures so they are not comparable. To continue to track your ACH rate by OASIS-based data, this data will continue to be reported on the CASPER Reporting System.

For Specifications for Home Health Claims-Based Utilization Measures, Click Here

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Encore-Special ODF for Hospice Providers

Did you miss the December 19th Open Door Forum that presented information about the Hospice Quality Reporting Program?

CMS announced that this ODF will have an encore recording available until midnight December 22nd

Agenda Topics included:

  • Updates about the upcoming availability of the data submission website
  • Information about how to access the data submission website and create a user account
  • Details about the data submission process
  • Question and Answer session

ENCORE CALL IN:  1-855-859-2056

CONFERENCE CODE:  81540883

 

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Special ODF for Hospice Providers

CMS is hosting a Special Open Door Forum for all hospice providers on December 19 from 1-2 pm EST. The Special ODF will present information about the Hospice Quality Reporting Program

Agenda Topics will include:

  • Updates about the upcoming availability of the data submission website
  • Information about how to access the data submission website and create a user account
  • Details about the data submission process
  • Question and Answer session
The Participant Dial in is: 1-800-837-1935
The Conference ID: 81540883

Return to www.thinkhomecare.org.

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