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There are 3 types of Home Health Quality Measures based on OASIS-C data: Process Measures, Outcome Measures, and Potentially Avoidable Events. Process measures have been reported since October 2010. Reporting of "Outcome" and "Potentially Avoidable Event" measures has undergone a static period to allow for collection of sufficient OASIS-C data and risk model development. This page contains information about the schedule for reporting measures, brief descriptions of each type of measure, and tables identifying which Home Health Quality Measures are risk adjusted and reported publicly. Reporting Schedule Update: New Home Health Quality Outcome and Potentially Avoidable Event Measures available beginning June 2011 A preview of the All Patients' Risk Adjusted Outcome Reports, including both "Outcome" and "Potentially Avoidable Event" (PAE) measures, will be made available to HHAs on CASPER beginning in June 2011. These preview reports will be based on OASIS-C data reported from April 2010 - March 2011, and risk adjusted using the newly developed prediction models. The OASIS data used to calculate the quality measures will be updated quarterly and represent a rolling 12 months of data. The Medicare Home Health Compare website will include a subset of these measures beginning in July 2011. See the 508 Transition Reporting Revised 04/13/2011 link below under Downloads for more detail and dates on scheduled measure reporting. Outcome Measures Outcome measures report a change (or lack of change) in patient condition during an episode of care. There are two types of outcomes--utilization outcomes and end-result outcomes. Higher values are preferable to lower values for end result outcomes, while lower values are preferable for utilization outcomes. Outcome measures are calculated based on a completed episode of care that begins with admission to a home health agency (or a resumption of care following an inpatient facility stay) and ends with discharge or transfer to inpatient facility. This is different than a Home Health Prospective Payment episode of 60 days. Risk Adjustment - All the outcome measures, except Emergency Department Use without Hospitalization, are risk adjusted. The risk adjustment methodology, using a predictive model developed specifically for each measure, compensates for differences in the patient population served by different home health agencies. In the Home Health Quality Outcomes Measure Table, located via the link for Tables for Outcome, Potentially Avoidable Event and Process Measures [ZIP 33 KB] in the Downloads section below, the OBQI outcome measures for which the predictive models did not meet the criteria R2 > 0.10 or C-statistic > 0.70 are designated with a pound sign (#) to highlight the fact that they have less robust risk adjustment. The double pound sign (##) for Emergency Department Use without Hospitalization indicates that the measure is not risk adjusted. For more information about the outcome measures please follow the link in the Downloads section below for the OBQI Manual. Potentially Avoidable Event Measures Potentially avoidable events serve as markers for potential problems in care because of their negative nature and relatively low frequency. 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. All the Potentially Avoidable Event Measures are adjusted for variation in patient characteristics. The predictive model for Development of Urinary Tract Infection did not meet the criteria R2 > 0.10 or C-statistic > 0.70 and so is designated with a pound sign (#) to highlight the fact it has less robust risk adjustment. Please check the table for "Home Health Quality Potentially Avoidable Event Measures" by accessing the link to Tables for Outcome, Potentially Avoidable Event and Process Measures [ZIP 33 KB] in the Downloads section below. For more information about the Potentially Avoidable Event Measures please follow the link in the Downloads section below for the OBQM Manual. Process Measures Process quality measures evaluate the rate of home health agency use of specific evidence-based processes of care. The OASIS-C process measures focus on high-risk, high-volume, problem-prone areas for home health care. These include measures pertaining to all or most home care patients, such as timeliness of home care admission, immunizations, and use of risk assessment tools for falls, pain, depression, and pressure ulcer development. As well, there are measures for specific diagnoses (heart failure, diabetes, pressure ulcers) and measures of care planning and clinical interventions delivered for patients experiencing certain symptoms (pain, depression). Process measures are calculated based on a completed episode of care that begins with admission to a home health agency (or a resumption of care following an inpatient facility stay) and ends with discharge or transfer to inpatient facility. This is different than a Home Health Prospective Payment episode of 60 days. Unlike the outcome and potentially avoidable event measures, process measures are not risk adjusted. Risk adjustment is not considered to be necessary for process measures because the processes being measured are appropriate for all patients included in the denominator (patients for whom the measure is not appropriate are excluded). Please check the table for "Home Health Quality Process Measures" by accessing the link to Tables for Outcome, Potentially Avoidable Event and Process Measures [ZIP 33 KB] in the Downloads section below. For more information about the process measures please follow the link in the Downloads section below for the PBQI Manual.
Page Last Modified: 01/09/2012 7:27:20 AM
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