Home Health Value-Based Purchasing (HHVBP) Leveraging External Improvement Resources for Success in HHVBP March 9, 2017 Prepared for CMS by the HHVBP Technical Assistance, contract number HHSM-500-2014-0033I. If you have suggestions for additional topics, please email the Help Desk at HHVBPquestions@cms.hhs.gov.
HHVBP Learning Event Structure HHVBP Model Curriculum Quality Improvement HHVBP Model Information Measures Improvement Strategies 2
Agenda Questions to Consider Overview of available resources for home health quality improvement Review of some of the Best Practice Intervention Packages (BPIPs) from the Home Health Quality (HHQI) National Campaign in detail Discussion and Q and A with Misty Kevech Resources
Handouts & Questions Handouts» Presentation Slides (PDF) Questions» Questions related to this webinar: May be submitted through the Q&A feature on your screen, OR» Questions on any HHVBP topic: Questions related to this webinar or related to any HHVBP topic may be submitted to the HHVBP Help Desk at HHVBPquestions@cms.hhs.gov
Console Overview 5
Leveraging Available Quality Improvement Resources
Questions to Consider 1. What tools does your agency use to improve HHVBP Model performance? 2. What is your current process for improving the performance of your agency in the HHVBP Model?
Available Resources for Improving Quality in Home Health CMS website:» Home Health Quality Initiative landing page» CMS Home Health Measures Tables» CASPER Reports HHVBP Environmental Scan Best Practice Intervention Packages (BPIPs) from the Home Health Quality (HHQI) National Campaign:» Medication Management (Focused)» Fall Prevention» Fundamentals of Reducing Hospitalizations
HHVBP Model Measure Set Data Source Type # of Measures in the HHVBP Model OASIS-based Outcome 7 Process 3 HHCAHPS Outcome 5 Claims Outcome 2 New Measures Outcome 3
Overview of CMS HHQI Website - Landing Page
Overview of CMS HHQI Website Quality Measures
Overview of CMS HHQI Website Quality Measures Tables How is my agency performing on these items? Is the agency utilizing appropriate best practices?» For safe ambulation?» For managing cognitive impairment?» For managing anxiety? Optimal patient functional level may equal improvement in measure performance
CASPER Reporting System
HHVBP Measures Included in CASPER Reports Measure Improvement in Ambulation-Locomotion Improvement in Bed Transferring Improvement in Bathing Improvement in Dyspnea Discharged to Community Improvement in Pain Interfering with Activity Improvement in Management of Oral Medications Acute Care Hospitalization: Unplanned Hospitalization during first 60 days of Home Health Emergency Department Use without Hospitalization Influenza Immunization Received for Current Flu Season Pneumococcal Polysaccharide Vaccine Ever Received Drug Education on All Medications Provided to Patient/Caregiver during all Episodes of Care Type Outcome Outcome Outcome Outcome Outcome Outcome Outcome Outcome Outcome Process Process Process
HHVBP Model Measure Set CAHPS-Based Measures Measure Type Data Source Care of Patients Outcome HHCAHPS Communications between Providers and Patients Outcome HHCAHPS Specific Care Issues Outcome HHCAHPS Overall Rating of Home Health Care Outcome HHCAHPS Willingness to Recommend the Agency Outcome HHCAHPS
HHVBP Environmental Scan Environmental scan of the literature conducted in 2015 and 2016, example HHCAHPS resources include:» Mullaney, T. (2016, April 18). How Agencies Can Rise to the 5-Star Ratings Challenge. Retrieved from http://homehealthcarenews.com/2016/04/how-agencies-can-rise-to-the- 5-star-ratings-challenge/» Greenberg, E. L. (2016). Reach for the Stars: It s Time to Focus on Optimizing Patient Experience of Care in Home Healthcare. Home Healthcare Now, 34(1), 50 51. Retrieved from http://www.nursingcenter.com/journalarticle?article_id=3265725&journ al_id=2695880&issue_id=3265513 Search the articles for evidenced based practices in order to improve agency performance in the HHVBP Model measure set.
Leveraging HHQI s Free Tools & Resources www.homehealthquality.org This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization supporting the Home Health Quality Improvement National Campaign, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. Publication number 11SOW-WV-HH-MMD-022117
What is HHQI? Goal: To improve the quality of care home health patients receive Special Project funded by Centers for Medicare & Medicaid Services Free evidence-based tools and resources Many networking opportunities with 17,000+ participants
Evidence-Based Practices Duke University, 2017
Best Practice Intervention Packages (BPIPs)
HHQI Complete Resource Library
HHVBP Model Measure Set OASIS-Based Measures Measure Type Data Source Improvement in Management of Oral Medications Outcome OASIS based Drug Education on All Medications Provided to Patient/Caregiver during all Episodes of Care Outcome OASIS based
Medication Management BPIP Focused BPIP Key areas: Reconciliation Adherence Knowledge
System Approach to Medication Reconciliation
Guiding Patients Toward Medication Adherence
Morisky Medication Adherence Scale Questions Yes No 1. Do you sometimes forget to take your [health concern] pill? 2. People sometimes miss taking their medications for reasons other than forgetting. Thinking over the past two week, were there any days when you did not take your [health concern] medication? 3. Have you ever cut back or stopped taking your medication without telling your doctor, because you felt worse when you took it? 4. When you travel or leave home, do you sometimes forget to bring along your [health concern] medication? 5. Did you take your [health concern] medication yesterday?* 6. When you feel like your [health concern] is under control, do you sometimes stop taking your medication? 7. Taking medication everyday is a real inconvenience for some people. Do you ever feel hassled about sticking to your [health concerns] treatment plan? 8. How often do you have difficulty remembering to take all your medications?** Never/rarely Once in a while Sometimes Usually All the time
Morisky Medication Adherence Scale Scoring Point Total Adherence Level 8 points High Adherence 6-7 points Medium Adherence <6 points Low Adherence Download the Morisky Medication Adherence Scale & Tip Sheet
10 Elements of Competency for Using Teach-back Effectively
HHQI University Courses
Oral Medication Management BPIP Medication Reconciliation Simplification Adherence Show Me & Teach-Back Assessment of patient s ability Interventions Discipline-specific tracks
HHVBP Model Measure Set OASIS-Based Measures Measure Type Data Source Improvement in Ambulation-Locomotion Outcome OASIS based Improvement in Bed Transferring Outcome OASIS based
Fall Prevention BPIP Causes & Treatment Fall Risk Assessment Organizational Culture Discipline-specific tracks
Fall Risk Assessment Algorithm
7 Steps to Medication Simplification
Tips for Living Checklists: How Safe Is Your Home? & Preventing Falls
The Gravity of Falls: Evidence-Based Prevention Strategies Webinar Recording & Slides: http://www.homehealthquality.org/webinars/falls Presenters Nancy Kimmons, PT Rehab Affiliates, Division of Main Line Health Michele James, RN-BC The Home Care Network, Jefferson University Hospitals Chuck Lally, Pharmacist University Hospitals Home Care Services Joanne M. Wile Avenmarg, OTR/L University Hospitals Home Care Services
HHVBP Model Measure Set Claims-Based Measures Measure Type Data Source Acute Care Hospitalization: Unplanned Hospitalization during first 60 days of Home Health Outcome Claims-based Emergency Department Use without Hospitalization Outcome Claims-based
Fundamentals of Reducing Hospitalizations BPIP Hospitalization Risk Assessments Underserved Populations Medication Management Care Transitions Disease/Behavioral Health Management Patient Self-Management Hospice/Palliative Care Telehealth Discipline-specific & Leadership actions
Call Me First Posters
ZONE Tools
Patient Self- Hospitalization Risk Assessment
Multimedia Module Download MP4 or watch on YouTube.
Discussion
Contact Information Misty Kevech mkevech@qualityinsights.org HHQI@qualityinsights.org www.homehealthquality.org This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization supporting the Home Health Quality Improvement National Campaign, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. Publication number 11SOW-WV-HH-MMD-022117
Resources & Reminders 45
Additional Resources CMS Home Health Quality Initiative page: https://www.cms.gov/medicare/quality-initiatives- Patient-Assessment- Instruments/HomeHealthQualityInits/index.html CMS Home Health Quality Training page: https://www.cms.gov/medicare/quality-initiatives- Patient-Assessment- Instruments/HomeHealthQualityInits/Home-Health- Quality-Reporting-Training.html CASPER Reporting Manual: https://www.qtso.com/hhatrain.html Home Health Quality Initiative Campaign: http://www.homehealthquality.org/home.aspx 2015 & 2016 Environmental Scans: HHVBP Connect
Mark Your Calendars Upcoming Webinar Topic Date Time Measures Improvement Strategies: OASIS Measure Improvement in Dyspnea Measures Improvement Strategies: Improvement in Management of Oral Medications Thursday, March 23, 2017 Thursday, April 6, 2017 All learning events will be held at 2 PM, Eastern Time. Please register via the HHVBP Connect Calendar. 2:00 PM (ET) 2:00 PM (ET)
Questions Do you have questions about the HHVBP Model? Contact the HHVBP Model Help Desk at HHVBPquestions@cms.hhs.gov. If you are experiencing technical issues with gaining access to the HHVBP Secure Portal or HHVBP Connect, please call: (844) 280-5628. Stay on the line until your issue is resolved.
HHVBP Connect Chatter Continue the Discussion on HHVBP Connect! https://app.innovation.cms.gov/hhvbp Connect/CommunityLogin
Thank You! Prepared for CMS by the HHVBP Technical Assistance, contract number HHSM-500-2014-0033I. If you have suggestions for additional topics, please email the Help Desk at HHVBPquestions@cms.hhs.gov.