Quality Outcomes
Review the record of each patient to look for trends in 60-day acute care hospitalizations as national HHVBP gets underway. For example, reexamining hospitalizations might show that patients under the care of a certain clinician are more likely to be admitted.
An on-call service can be a key part of keeping your patients out of the hospital and ER, and potentially impact your overall rating in patient surveys.
Smart use of paraprofessionals can help cut costs. It is less expensive than skilled professional services and paraprofessionals are able to provide services following the plan of care set up by the overseeing skilled discipline.
When looking to achieve organizational goals involving multiple service lines, it is best to have service-line specific QAPI committees that are facilitated by one overall QAPI manager.
One of the areas agencies need to focus on improving is discharge to the community, as this area is not only heavily scrutinized, but affects patient satisfaction scores in HHCAHPS.
Working to improve in emergency department without hospitalization rates can have effects beyond the one measure. Patients often do not want to go to the emergency department, so agencies that can keep their patients home may see an increase in the patient satisfaction scores, which is another piece of HHVBP.
Analytics on productivity, utilization (overall visits and discipline visits) and recertification rates also can help identify outliers among case managers and areas for further review. If you have clinicians who are never meeting productivity expectations, determine whether they’re spending enough time in the home and whether their patients are more complex.
Agencies often fall into the trap of passively monitoring instead of taking action to observe, assess, teach and instruct, which can help keep patients with diabetes out of the hospital.
One of the best ways to start laying the foundation now for future Home Health Value-Based Purchasing (HHVBP) bonuses is to focus fresh attention on your patient satisfaction efforts.
Everything that clinicians do determines an agency’s revenue, including their OASIS answers, code choices and how they conduct visits — with impacts on period payments, as well as determining an agency’s quality reporting scores and star ratings.


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