CMS has made several updates to the Home Health Quality Reporting Program, including two important updates impacting scores on the Discharge to Community – Post Acute Care (DTC-PAC) measure.
Effective with the October update of Care Compare, CMS has decreased the lookback period for risk adjustment on the DTC-PAC measure from 180 days to 90 days. This is to align the measure with other settings, including SNFs, LTCs and IRFs.
Other changes include:
- Using the Medicare Beneficiary Identifier (MBI) instead of Health Insurance Claim Number (HICN) as the primary beneficiary identifier used in calculating the measures,
- Updating the code lists used to identify potentially preventable hospitalizations and Hierarchical Condition Categories (HCCs) to reflect updates for the FY2026 ICD-10-Clinical Modification (ICD-10-CM), ICD-10-Procedure Coding System (ICD-10-PCS), and Healthcare Common Procedure Coding System (HCPCS) code lists.
CMS also plans to change the specifications of the DTC-PAC measure by including Medicare Advantage records in addition to Medicare fee-for-service claims.
The updated measure will first be reported on provider preview reports in July 2027 and first publicly reported on Care Compare in October 2027.
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