6/1/2010 Making HHCAHPS Easy! Understanding HHCAHPS and Using it - - PDF document

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6/1/2010 Making HHCAHPS Easy! Understanding HHCAHPS and Using it - - PDF document

6/1/2010 Making HHCAHPS Easy! Understanding HHCAHPS and Using it to Your Advantage Home Care Alliance of Massachusetts 2010 Spring Conference Cathy King National Director of www.deyta.com Business Development P: 888..893.1937 E:


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SLIDE 1

6/1/2010 1

Making HHCAHPS Easy!

Understanding HHCAHPS and Using it to Your Advantage

Home Care Alliance of Massachusetts 2010 Spring Conference

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Cathy King National Director of Business Development

T

  • day’s Age nda

Part I.

– HH-CAHPS Overview – Survey Design and Process – Public Reporting

Part II

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Part II.

– Tips on Choosing a Vendor – Common Pricing Models – Agency Preparation Tips

About De yta

  • Specialists in home health and hospice satisfaction

– Administering satisfaction surveys since 1993 – Currently work with over 2,000 home health and hospice agencies, and growing…

  • CMS approved for HHCAHPS

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

pp

  • “Satisfaction Technology Platform”

– Scalable, effectively supporting multi-site organizations – Sophisticated system, simple to use

  • Largest satisfaction benchmarks in the nation
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6/1/2010 2

  • We’re specialists in home health satisfaction

– We understand your challenges – Experts in satisfaction data collection

  • Operational, business centric approach

– Month of service reports – Multi-level benchmarking structure Ad H ti

Be ne fits of Using De yta

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Ad Hoc reporting

  • Dedicated client service team

– We make implementation easy – Ongoing training on results interpretation

  • Value based pricing model for HHCAHPS

– CMS required second wave mailing is included – All reporting and comments are included

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

HHCAHPS Ove r vie w What is Home He alth Car e CAHPS

  • What is CAHPS?
  • Consumer Assessment of Healthcare Providers and

Systems

  • Standardized national survey for home health

patients

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

patients

  • Measures patient perception of care
  • Component of Home Health Quality Initiative
  • Changing focus from quantity to quality
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6/1/2010 3

CMS Obje c tive s with HHCAHPS

  • Produce comparable data
  • Create incentives for agencies to improve quality
  • Enhance public accountability

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Perception of the clinician’s ability to deliver

– Details on home care services, visits and timing – Safety and falls prevention – Medication instructions – Pain management

What is HHCAHPS Me asur ing

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Pain management – Sensitivity to patient needs – Courtesy and respect – Listening

  • Perception of the HHA’s responsiveness

HHCAHPS Pr

  • gr

am Highlights

  • Final Rule HH PPS CY2010 …

– Medicare-certified agencies – CMS mandates use of approved survey vendor – Results will be publically reported on HHC

  • Only Medicare and/or Medicaid patients

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Only Medicare and/or Medicaid patients

– For CMS data reporting – Many HHA’s surveying all patients for accurate results

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6/1/2010 4

HHCAHPS Pr

  • gr

am Highlights

  • Must meet two requirements starting in 2010 or

receive a 2% reduction in reimbursement starting in CY 2012

– Conduct Dry Run in Q3 2010

Continuously collect HHCAHPS survey data as of

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Continuously collect HHCAHPS survey data as of

10/1/2010

– Qualifies for full market basket update in CY2012

  • Less than 60 survey eligible patients per year
  • Exemption form on www.homehealthcahps.org
  • Form completed by 6/16/2010
  • Provide patient count from 4/1/09 – 3/31/10

Par tic ipation E xe mptions

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Unduplicated patients

  • Exempt from data collection from Q3 2010 –Q2 2011
  • Annual exemption reporting needed
  • Medicare-certified on or after 4/1/2011 for

payments to be made in CY2012 – Should begin process as soon as possible

  • A reconsideration and appeals process being

Par tic ipation E xe mptions

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

developed – Details in CY 2012 HH payment rule

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6/1/2010 5

F r e e Infor mation

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Sur ve y De sign and Pr

  • c e ss

Sur ve y Instr ume nt

  • Standard set of questions

35 question survey tool Questions 1-25 always asked first Questions 26-34 “About You” - demographic

  • Supplementary questions (optional)

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Supplementary questions (optional)

Deyta Satisfaction Process Measures Includes satisfaction for all Visit types and Disciplines Best practice of most successful agencies

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6/1/2010 6

T he HHCAHPS Sur ve y T

  • ol

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Monthly random sample of patients:

– Medicare and/or Medicaid (for minimum compliance) – At least 18 yrs – Are not deceased when sample frame is drawn – Current or discharged who had at least one skilled visit

Patie nt E ligibility Cr ite r ia

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during sample month

– At least two skilled visits in 60 day look back period – No maternity care – Not receiving hospice – Not recently surveyed (during 5 months prior) – Not requested “no publicity status”

Sur ve y Pr

  • c e ss

HHCAHPS HHCAHPS

  • 1. Agency sends
  • 1. Agency sends

monthly data file to monthly data file to CMS Approved CMS Approved Survey Vendor Survey Vendor

  • 2. Vendor determines
  • 2. Vendor determines

eligible patients, eligible patients, conducts sampling conducts sampling and distributes and distributes survey survey

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Process Process

  • 4. Monthly reporting
  • 4. Monthly reporting
  • f results on to
  • f results on to

HHA HHA

  • 3. Vendor compiles
  • 3. Vendor compiles

results and results and submits data to submits data to CMS CMS

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6/1/2010 7

  • Patient-level data elements submitted

monthly to vendor

  • Required data elements

– OASIS Vi it/T ti d

Monthly Data F ile

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– Visit/Transaction records – Patient Information/Demos

  • Random sampling and survey distribution
  • Timing of Survey Distribution

– Distributed at the beginning of the month – Surveys received by patient within 3 weeks – Second wave of surveys if no response in first 3

Sur ve y Cyc le

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Seco d a e o su eys

  • espo se

st 3 weeks – Six week field period allowed from the first date surveys were mailed – HHCAHPS surveys received after the cut off period will not be reported to CMS

Data Colle c tion Mode

Survey data can be collected using one of three data collection modes:

– Mail – Telephone – Mixed mode (mail with telephone follow-up)

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

( p p)

Estimates of Response Rates Associated with Similar Surveys per CMS

Mode Response Rate Sample size for 25 responses/month

Mail Only 30% 84 Phone Only 35% 72 Mixed 40% 63

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6/1/2010 8

Managing the Sample

  • HHA’s should target 300 completed surveys per year

– Smooth inflow of completed surveys during course of the year – Monthly sampling protocols – Automatically adjust the random sample size to generate the new monthly requirement

  • If patient count will not reach 300, then survey 100% of patients

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

p , y p

Proportionate Random Sampling Deyta will first determine the minimum number of records needed to maintain the goal of 300 returns per year per CCN. Set n = maximum between this value and the goal for that CCN. The data “k” will be split into mutually exclusive sets. For each download we will determine for i=1 to k N = the number of patients for the CCN submitted N = the number of patients to sample for the CCN N = the number of patients in the ith strata the sum Ni = N pi = the proportion of patients in the ith strata pi = Ni / N and sum pi = 1 Ni = N * pi we will round up to be conservative on the sample size. Thus sum Ni>= N

  • 3/9/10 Addendum to P&G Manual Chapter VIII

“…CMS has decided to allow survey vendors to share information that could link an HHCAHPS respondent to his or her answers under

  • ne condition only:

– survey vendors can share a respondent’s survey responses linked to his or her name with the client HHA only if the patient (hereafter referred to in this document as “the respondent) gives the survey vendor permission to do so.”

Patie nt Confide ntiality

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A Comple te d Sur ve y

  • Definition of a Completed Survey

– A survey is considered to be “complete” if at least 50 % of the questions applicable to all sample members (Questions 1–11, 15–21, and 24–25) are answered. – Skip pattern and “About You” items are not included in this calculation

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com Exhibit 9.1 Steps for Determining if a Questionnaire Meets Completeness Criteria Sum the number of questions that have been answered by the respondent that are applicable to all patients. These include questions 1–11, 15–21, and 24–25. R = total number of questions answered Divide the total number of questions answered by 20, which is the total number of questions applicable to all patients, and then multiply by 100 to determine the percent. Percentage Complete = (R 20 ) 100 If the Percentage Complete is greater than or equal to 50%, then assign the applicable survey completed disposition code (code 110 or 120) to indicate that the case meets the definition of a completed survey. Otherwise, assign the disposition code for break off (code 310) to the case.

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6/1/2010 9

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Public Re por ting Me asur e s for Public Re por ting

  • 2 Global Measures

– Overall rating of home health care (0-10) – Would recommend the HHA (yes/no)

  • 3 Composite Measures

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  • 3 Composite Measures

– Care of patients – Communication between providers and patients – Specific care issues (medicines, pain, safety)

Global Que stion - Ove r all Rating of Car e

  • Using a number from 0 to 10

– 0 is the worst home health care possible – 10 is the best home health care possible

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

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6/1/2010 10

Global Que stion - Age nc y Re c omme ndation

  • Would you recommend this agency to

family/friends in need of home health care?

– Definitely yes – Probably yes

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Probably no – Definitely no

Car e of Patie nts Composite

HHCAHPS Question Response Scale

  • Q9. In the last 2 months of care, how often did home health providers

from this agency seem informed and up-to-date about all the care or treatment you got at home? Never, Sometimes, Usually, Always

  • Q16. In the last 2 months of care, how often did home health providers

from this agency treat you as gently as possible? Never, Sometimes, Usually, Always

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Q19. In the last 2 months of care, how often did home health providers

from this agency treat you with courtesy and respect? Never, Sometimes, Usually, Always

  • Q24. In the last 2 months of care, did you have any problems with the

care you got through this agency? Yes, No

Communic ations Be twe e n Pr

  • vide r

s/ Patie nts Composite

HHCAHPS Question Response Scale

  • Q2. When you first started getting home health care from this agency, did

someone from the agency tell you what care and services you would get? Never, Sometimes, Usually, Always

  • Q15. In the last 2 months of care, how often did home health providers

from this agency keep you informed about when they would arrive at your home? Never, Sometimes, Usually, Always

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Q17. In the last 2 months of care, how often did home health providers

from this agency explain things in a way that was easy to understand? Never, Sometimes, Usually, Always

  • Q18. In the last 2 months of care, how often did home health providers

from this agency listen carefully to you? Never, Sometimes, Usually, Always

  • Q22. In the last 2 months of care, when you contacted this agency’s office

did you get the help or advice you needed? Yes, No

  • Q23. When you contacted this agency’s office, how long did it take for you

to get the help or advice you needed? Same day, 1 to 5 days, 6 to 14 days, More than 14 days

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6/1/2010 11

Spe c ific Car e Issue s Composite

HHCAHPS Question Response Scale

  • Q3. 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? Yes, No

  • Q4. When you started getting home health care from this agency, did someone from

the agency talk with you about all the prescription medicines you were taking? Yes, No

  • Q5. When you started getting home health care from this agency, did someone from

the agency ask to see all the prescription medicines you were taking? Yes, No

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

the agency ask to see all the prescription medicines you were taking?

  • Q10. In the last 2 months of care, did you and a home health provider from this

agency talk about pain? Yes, No

  • Q12. In the last 2 months of care, did home health providers from this agency talk

with you about the purpose for taking your new or changed prescription medicines? Yes, No

  • Q13. In the last 2 months of care, did home health providers from this agency talk

with you about when to take these medicines? Yes, No

  • Q14. In the last 2 months of care, did home health providers from this agency talk

with you about the important side effects of these medicines? Yes, No

Patie nt Char ac te r istic s: “About You”

  • Health status
  • Age
  • Sex
  • Living Situation

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Education
  • Race
  • Language
  • Help completing the survey
  • Only HHCAHPS survey items will be reported
  • Reported results will be based on a rolling 12

months (four quarters of data)

  • Updated each quarter

Public Re por ting De tails

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Begin in spring 2011
  • Review period before public reporting each

quarter

  • Dry Run data not reported
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6/1/2010 12

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Choosing A Ve ndor T ips

  • 1. CMS Approved
  • 2. What is their experience in home health and

satisfaction?

– How long have they been doing this?

T ips on Choosing a Ve ndor ?

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Long term viability? – Trust them to ensure you comply with regs? – Supplemental questions for useful information?

  • 3. Entry-level product or complete solution?
  • 4. Reporting

– What is included – Usefulness – Frequency

T ips on Choosing a Ve ndor ?

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Frequency

  • 5. Comments included

– Handle anonymous patient comments – Email Alerts – Online reporting by branch/team – Monthly reporting

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6/1/2010 13

  • 6. Dedicated support

– Implementation and data delivery – CMS management – Report analysis

7 Ability to handle sampling and patient protocols

T ips on Choosing a Ve ndor

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • 7. Ability to handle sampling and patient protocols

– Data cleansing and patient selection – Ongoing compliance algorithms – Simultaneous surveys

  • 8. Pricing Consideration

– What is pricing model and components? – What data collection mode do you offer? – What is included in the base pricing? – Does it cost more for comment reporting?

T ips on Choosing a Ve ndor

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Does it cost more for comment reporting? – What type of reports are included? – Does it cost more for dedicated service? – Is there a data fee? – Custom reports?

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Common Pr ic ing Mode ls

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6/1/2010 14

Pay per Patient – License fee – Fee per patient – Includes second wave mailings, reporting (comments) data support, guarantee CMS compliance, dedicated customer service

Pr ic ing Mode ls

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customer service Example – 1 agency (CCN) with 1000 patients per year – $500 (Base Fee) – $3 per patient Total Cost: $500 + ($3 * 1000) = $ 3,500

Pay per Survey – License fee – Per survey fee – Dependant on response rate. Charges for comments and custom reports.

Pr ic ing Mode ls

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Example

– 1000 patients – $500 base fee – $2.45 per survey and 80% second wave mailing

Total Cost: $4,910 $500 + (1000 * $2.45)+(1000*.80*$2.45)

Pr ic ing Mode ls

Compliance Pricing

– Pricing per provider number – All Inclusive of second wave mailings – Based on number of patients – Billed up front for the year or monthly at your request

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Contract term 24 months

Annual Patients Surveyed Standard Annual Fee HCAM Members Annual Fee (10% discount) 61‐250 $1,200 $1,080 251‐500 $2,100 $1,890 501‐1000 $3,300 $2,970 1001‐1500 $4,500 $4,050

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www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Age nc y Pr e par ation T ips

  • Education team on HHCAHPS
  • Define expectations of team
  • Build communication skills

– Language challenges with patient

  • Familiarize with HHCAHPS questions

Age nc y Pr e par ation T ips

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

  • Familiarize with HHCAHPS questions
  • Set and review satisfaction goals

– Locations – Teams – Disciplines – Timeframes

  • Teach and foster customer centric approach

– Develop service training programs

  • Tie customer centric behaviors to performance

– Goals, Incentives, Evaluations

Age nc y Pr e par ation T ips

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Feedback – Orientation

  • Revise corporate scorecards or incentive programs
  • Create HHCAHPS task force

– Multi disciplined

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6/1/2010 16

  • Build HHCAHPS survey into orientation and training
  • Identify improvement initiatives and revise systems
  • Update admissions information

– Advise patient to expect survey

Age nc y Pr e par ation T ips

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

– Build pro-active partnership with patient – “Tell Me” if my care is not exceeding expectations

  • Exceptional clinical notation of communication

issues – Helps set expectations for all visits

  • Home Health Care CAHPS Survey informational web site

– https://homehealthcahps.org/

  • Federal Register HHPPS CY 2010 Final Rule
  • http://edocket.access.gpo.gov/2009/pdf/E9-26503.pdf
  • NQF Endorsement of New Quality and Patient Experience

S d d i H H l h C

Additional Resources

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

Standards in Home Health Care

– http://www.qualityforum.org/news/releases/04022009.asp

  • Agency for Healthcare Research Quality

– http://www.cahps.ahrq.gov/default.aspwww.cms

T hanks for L iste ning!!!

Got Questions – Want Clarification – Need Vendor

Cathy King National Director of Business Development

www.deyta.com P: 888..893.1937 E: homehealth@deyta.com

p e: cking@deyta.com p: 502.379.6161