A new list of Measures Under Consideration (MUC) is providing some specific examples of the changes CMS is planning for the Home Health CAHPS through future rulemaking.
 
The list includes new wording for some existing questions, as well as examples that will be offered within the survey that help the patient when responding.
 
The five proposed measures were included in the MUC list released by CMS on Nov. 18.  In the home health payment final rule, released Nov. 1, CMS included a brief note that it was moving ahead with pre-rulemaking on a shorter HHCAHPS survey.
 
With the MUC list, we’re seeing some of the ways that the survey will be different. For example, CMS is proposing a “Talk about home safety” measure.
 
The existing question asks, “When you first started getting home health care from this agency, did someone from the agency talk with you about how to set up your home so you can move around safely?”
 
The updated question, according to the MUC listing, asks whether someone from the agency talked about "ways to help make your home safer? For example, they may have suggested adding grab bars in the shower or removing tripping hazards.”
 
Some of the questions make significant changes in the timing that CMS is inquiring about. For example, the proposed “Review medicines” measure is based on responses to the question “Has someone from this agency ever reviewed the prescribed and over-the-counter medicines you were taking? For example, they might have asked you to show them your medicines and talked with you about how and when to take each one.”
 
The existing question specifically references “when you started getting home health care,” as opposed to the new "ever reviewed" language, and it offers no examples for the respondent.
 
Here’s a brief summary of all five HHCAHPS measures included on the 2024 MUC list.
 
Care of Patients is a multi-item composed of responses to the following survey items:
  6.  In the last 2 months of care, how often did home health staff from this agency seem to be aware of all the care or treatment you were getting at home?
  7.  In the last 2 months of care, how often did home health staff from this agency treat you with care – for example, when moving you around or changing a bandage?
  10.  In the last 2 months of care, how often did home health staff from this agency treat you with courtesy and respect?
  11.  In the last 2 months of care, how often did you feel that home health staff from the agency cared about you as a person?
  13.  In the last 2 months of care, how often have the services you received from this agency helped you take care of your health?"             
The items in the HHCAHPS Care of Patients measure use a “Never/Sometimes/Usually/Always” response scale. This measure looks for the number of respondents who answer “Always.”
 
Communications Between Providers and Patients is a multi-item measure composed of responses to the following survey items:
  5.  In the last 2 months of care, how often did home health staff from this agency keep you informed about when they would arrive at your home?
  8.  In the last 2 months of care, how often did home health staff from this agency explain things in a way that was easy to understand?
  9.  In the last 2 months of care, how often did home health staff from this agency listen carefully to you?
  12.  In the last 2 months of care, did home health staff from this agency provide your family or friends with information or instructions about your care as much as you wanted?
  16.  When you contacted this agency’s office, did you get the help or advice you needed?"  
The items in the HHCAHPS Communications Between Providers and Patients measure use a “Never/Sometimes/Usually/Always” response scale for items 5, 8, and 9. The measure looks for the number of respondents who answer “Always.” For items 12 and 16, the response scale is Yes/No, with the measure looking for the number of respondents who answer “Yes."
 
Talk About Home Safety is a single-item measure based on the responses to this item: When you first started getting home health care from this agency, did someone from the agency talk about ways to help make your home safer? For example, they may have suggested adding grab bars in the shower or removing tripping hazards.               
The Talk About Home Safety measure uses a “Yes/No” response scale. The measure is looking for the number of respondents who answer “Yes.”
 
Review Medicines is based on the responses to this item:
Has someone from this agency ever reviewed the prescribed and over-the-counter medicines you were taking? For example, they might have asked you to show them your medicines and talked with you about how and when to take each one.           
The Review Medicines measure uses a “Yes/No” response scale. The measure is looking for the number of respondents who answer “Yes.”
 
Talk About Medicine Side Effects is based on the responses to this item:
In the last 2 months of care, did home health staff from this agency talk with you about any side effects of your medicines?
The Talk About Medicine Side Effects measure uses a “Yes/No” response scale. The measure is looking for the number of respondents who answer “Yes.”      
 
The MUC list will be under pre-rulemaking measure review through January, with recommendations published by Feb. 1.
 
The comment period is expected to run from Nov. 25 to Dec. 30. See information on providing comments at https://p4qm.org/media/3166.