Home Health Star Rating Measures No Longer Impacted By Declining Patients Who Elect Hospice!

Written By Annette Lee

Update to the Home Health Quality Reporting Program Measure Calculations and Reporting User’s Manual, Version 2.0


The HH QRP QM User’s Manual has been updated to reflect quality measure changes since the Manual Addendum Update in October 2020. These changes include measure additions, removals, corrections, or clarifications as needed. Please visit Home Health Quality Measures and reference the updated Manual and summary listing of changes in the QM Manual V2 Change Table in the “Downloads” section of the webpage.

These changes are retroactive and in place as of the beginning of 2023. Risk adjustment has historically been used by CMS to “level the playing field” in quality outcomes, for agencies who have extraordinarily difficult patients with multiple co-morbidities, lack of caregiver, etc.

One of the most notable changes is that CMS will now provide an exemption on many key quality measures that impact the five star rating when a patient has been discharged from home health due to a hospice election. These exemptions include:

• Improvement in Ambulation - Locomotion

• Improvement in Bed Transferring

• Improvement in Bathing

• Improvement in Management of Oral Medications

• Improvement in Dyspnea

Annette Lee

Founder Annette Lee built Provider Insights to give home health and hospice providers peace of mind. She’s had decades of experience at CMS and provided many years of consultancy services—including contracting as a Medicare Administrator with MAC.

She speaks Medicare-ese fluently and knows how to make the most complicated rules make sense for patient-centered providers who don’t have the time to dissect every rule. Agencies that work with Provider Insights can rest assured they’re fully compliant with the regulations that are in place today. And they’ll stay compliant when those regulations change tomorrow.

https://www.providerinsights.com/
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