We also notice a significant increase in our ACH and Emergency room use without hospitalizations in this final IPR. This impacted our TPS score significantly.
Does anyone have any additional information as to what specifically CMS meant in their statement:
"Due to recent data system changes and updates in processing of HHVBP claims-based measures, CMS has made revisions to these measures."
Hoping to keep this discussion going as others review their IPRs.
Kim Portello PT, COS-C
Director of Quality and Patient Safety
Home and Community Based Services- Hebrew SeniorLife
781-234-9900
kimportello@hsl.harvard.edu
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Kim Portello
Director of Quality
Hebrew SeniorLife Home Care
Dedham MA
+1 (781) 234-9900
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Original Message:
Sent: 06-13-2024 09:39
From: Bonita Westover
Subject: HH VBP FINAL 3RD QTR ACH/ED
Yes! A huge difference with our ACH scores much higher. Not sure if you saw the language in the Final IPR communication from CMS:
"Due to recent data system changes and updates in processing of HHVBP claims-based measures, CMS has made revisions to these measures."
Even before the "data system changes and updates in processing" CMS has always said our ACH claims were much higher than what we track via SHP. We requested review from CMS in the past and they stood by their numbers. We wrote a custom report in Epic to look for patients discharged from Home Health who had a hospital visit within 60 days of HH start of care. We found few patients who visited hospital after HH discharge. (That only captures patients who remain in our healthcare system, but that is the majority of our HH patients.)
We are unclear how it is that CMS finds so many more hospitalization claims for HH patients than we know about. It's pretty demoralizing.
Bonita (Boni) Westover | Quality Assurance Analyst - Quality
SSM Health at Home
2802 Walton Commons Lane
Madison, WI 53718
Phone: 608-241-6922
Cell: 608-219-7330
bonita.westover@ssmhealth.com
SSMHealthatHomeWI.com
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Original Message:
Sent: 6/12/2024 5:52:00 PM
From: Tonya Salzman
Subject: HH VBP FINAL 3RD QTR ACH/ED
Good Evening:
I was wondering if other agencies had a significant difference between the preliminary 3rd QTR ACH/ED and the Final that was sent yesterday?
Thank You
With the Final Report
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Tonya Salzman RN
QAPI Manager
HomeCare Maryland, LLC
Owings Mills MD
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