Making HHCAHPS Easy! Making HHCAHPS Easy! Understanding HHCAHPS and - - PowerPoint PPT Presentation

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Making HHCAHPS Easy! Making HHCAHPS Easy! Understanding HHCAHPS and - - PowerPoint PPT Presentation

Making HHCAHPS Easy! Making HHCAHPS Easy! Understanding HHCAHPS and Using it to Your Advantage Using it to Your Advantage HCAF 2010 Annual Conference Bill Bassett ill VP, Home Health Care www.deyta.com P: 888..893.1937 E:


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SLIDE 1

Making HHCAHPS Easy! Making HHCAHPS Easy!

Understanding HHCAHPS and Using it to Your Advantage Using it to Your Advantage

HCAF 2010 Annual Conference

ill

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

Bill Bassett VP, Home Health Care

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SLIDE 2

T

  • day’s Age nda

Part I.

– HH-CAHPS Overview – Survey Design and Process

P bli R ti

– Public Reporting

Part II. Tips on Choosing a Vendor

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

g y p p

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

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SLIDE 3

About De yta

  • Specialists in home health and hospice satisfaction

p p

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

  • CMS approved for HHCAHPS
  • “Satisfaction Technology Platform”

gy

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

  • Largest satisfaction benchmarks in the nation

Largest satisfaction benchmarks in the nation

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

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SLIDE 4

Be ne fits of Using De yta

  • We’re specialists in home health satisfaction

– We understand your challenges – Experts in satisfaction data collection

  • Operational, business centric approach

– Month of service reports p – Multi-level benchmarking structure – Ad Hoc reporting

  • Dedicated client service team

Dedicated client service team

– We make implementation easy – Ongoing training on results interpretation

Value based pricing model for HHCAHPS

  • 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

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SLIDE 5

HHCAHPS Ove r vie w

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

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SLIDE 6

What is Home He alth Car e CAHPS

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

Systems

  • Standardized national survey for home health
  • Standardized national survey for home health

patients

  • Measures patient perception of care

p p p

  • Component of Home Health Quality Initiative
  • Changing focus from quantity to quality

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

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SLIDE 7

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

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SLIDE 8

What is HHCAHPS Me asur ing

  • Perception of the clinicians' ability to deliver

– Details on home care services, visits and timing – Safety and falls prevention Medication instructions – Medication instructions – Pain management – Sensitivity to patient needs Sensitivity to patient needs – Courtesy and respect – Listening

  • Perception of the HHA’s responsiveness

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

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SLIDE 9

HH-CAHPS Pr

  • gr

am Highlights

  • Final Rule HH PPS CY2010 …

– Medicare-certified agencies – CMS mandates use of survey vendor

Results will be publically reported on HHC

– Results will be publically reported on HHC

  • Only Medicare and/or Medicaid patients

– For CMS data reporting For CMS data reporting – Many HHAs surveying all patients for accurate results

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

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SLIDE 10

HH-CAHPS 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

– Conduct Dry Run in Q3 2010 – Continuously collect HHCAHPS survey data as of

10/1/2010

– Qualifies for full market basket update in CY2012

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

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SLIDE 11

Par tic ipation E xe mptions

  • Less than 60 survey eligible patients per year

y g p p y

  • Exemption form on www.homehealthcahps.org
  • Form completed by 6/16/2010
  • Provide patient count from 4/1/09 – 3/31/10

– Unduplicated patients f f Q Q

  • Exempt from data collection from Q3 2010 –Q2 2011
  • Annual exemption reporting needed

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

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SLIDE 12

Par tic ipation E xe mptions

  • Medicare-certified on or after 4/1/2011 for

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

developed – Details in CY 2012 HH payment rule

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

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SLIDE 13

F r e e Infor mation

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

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SLIDE 14

Sur ve y De sign and Pr

  • c e ss

y g

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

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SLIDE 15

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

Questions 26-34 About You - demographic

  • Supplementary questions (optional)

Deyta Satisfaction Process Measures

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

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

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SLIDE 16

T he HHCAHPS Sur ve y T

  • ol

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

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SLIDE 17

Patie nt E ligibility Cr ite r ia

  • Monthly random sample of patients:

M di d/ M di id (f i i li )

– Medicare and/or Medicaid (for minimum compliance) – At least 18 yrs – Are not deceased when sample frame is drawn

p

– Current or discharged who had at least one skilled visit

during sample month At l t t kill d i it i 60 d l k b k i d

– At least two skilled visits in 60 day look back period – No maternity care – Not receiving hospice

g p

– Not recently surveyed (during 5 months prior) – Not requested “no publicity status”

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

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SLIDE 18

Sur ve y Pr

  • c e ss
  • 1. Agency
  • 1. Agency sends

sends monthly monthly data data file to file to

  • 2. Vendor determines
  • 2. Vendor determines

eligible patients, eligible patients,

  • y
  • y da a

da a e o e o CMS Approved CMS Approved Survey Vendor Survey Vendor g p g p conducts sampling conducts sampling and distributes and distributes survey survey

HHCAHPS HHCAHPS Process Process

4 M thl ti 4 M thl ti y 3 V d il 3 V d il

  • 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

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

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SLIDE 19

Monthly Data F ile

  • Patient-level data elements submitted

monthly to vendor

  • Required data elements

– OASIS – Visit/Transaction records Patient Information/Demos – Patient Information/Demos

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

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SLIDE 20

Sur ve y Cyc le

  • Random sampling and survey distribution

Timing of Survey Distribution

  • Timing of Survey Distribution

– Distributed at the beginning of the month – Surveys received by patient within 3 weeks Surveys received by patient within 3 weeks – Second wave of surveys if no response in first 3 weeks – Six week field period allowed from the first date surveys were mailed HHCAHPS surveys received after the cut off period – HHCAHPS surveys received after the cut off period will not be reported to CMS

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

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SLIDE 21

Data Colle c tion Mode

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

– Mail – Telephone

Telephone

– Mixed mode (mail with telephone follow-up)

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

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

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SLIDE 22

Managing the Sample

  • HHAs should target 300 completed surveys per year

Smooth inflow of completed surveys during course of the 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 monthly requirement

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

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. F h d l d ill d t i f i 1 t k 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

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

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

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SLIDE 23

Patie nt Confide ntiality

  • 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 ith th li t HHA l if th ti t (h ft f d t i thi 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.”

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

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SLIDE 24

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 – 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 Skip pattern and About You items are not included in this calculation

Exhibit 9.1 Steps for Determining if a Questionnaire Meets Completeness Criteria 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

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

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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SLIDE 25

Public Re por ting p g

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

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Me asur e s for Public Re por ting

  • 2 Global Measures

2 Global Measures

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

  • 3 Composite Measures

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

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

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SLIDE 27

Global Que stion - Ove r all Rating of Car e

  • Using a number from 0 to 10

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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SLIDE 28

Global Que stion - Age nc y Re c omme ndation

  • Would you recommend this agency to

Would you recommend this agency to family/friends in need of home health care?

– Definitely yes – Probably yes – Probably no D fi it l – Definitely no

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

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SLIDE 29

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

Never, Sometimes, Usually,

  • 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

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

  • 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 this agency treat you with courtesy and respect? Always

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

you got through this agency? Yes, No

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

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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

f th t ll h t d i ld Never, Sometimes, Usually, Al someone from the agency tell you what care and services you would get? 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 Never, Sometimes, Usually, Always g y p y y y home? y

  • 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

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

  • 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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SLIDE 31

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 agency talk with you about how to set up your home so you can move around safely?

  • 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 Q10 I h l 2 h f did d h h l h id f hi lk Y N

  • 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

b t th f t ki h d i ti di i ? Yes, No about the purpose for taking your new or changed prescription medicines?

  • 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

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

  • 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

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SLIDE 32

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

  • Health status
  • Age
  • Sex
  • Living Situation
  • Education

R

  • Race
  • Language
  • Help completing the survey
  • Help completing the survey

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

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SLIDE 33

Public Re por ting De tails

  • Only HHCAHPS survey items will be reported

Only HHCAHPS survey items will be reported

  • Reported results will be based on a 12 months

(four quarters of data

  • Results will be a rolling 12 months
  • Updated each quarter
  • Begin in spring 2011
  • Review period before public reporting each

quarter

  • Dry Run data not reported

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

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SLIDE 34

Choosing A Ve ndor T ips g p

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

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SLIDE 35

T ips on Choosing a Ve ndor ?

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

satisfaction?

– How long have they been doing this? – Long term viability? g y – Trust them to ensure you comply with regs? – Supplemental questions for useful pp q information?

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

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SLIDE 36

T ips on Choosing a Ve ndor ?

  • 3. Entry-level product or complete solution?

4 Reporting

  • 4. Reporting

– What is included – Usefulness – Usefulness – Frequency

  • 5. Comments included
  • 5. Comments included

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

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

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SLIDE 37

T ips on Choosing a Ve ndor

  • 6. Dedicated support

I l t ti d d t d li – Implementation and data delivery – CMS management – Report analysis – Report analysis

  • 7. Ability to handle sampling and patient protocols

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

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

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SLIDE 38

T ips on Choosing a Ve ndor

  • 8. Pricing Consideration

Wh t i i i d l d t ? – What is pricing model and components? – What data collection mode do you offer? – What is included in the base pricing? – What is included in the base pricing? – Does it cost more for comment reporting? – What type of reports are included? yp p – 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

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SLIDE 39

Common Pr ic ing Mode ls g

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

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SLIDE 40

Pr ic ing Mode ls

Pay per Patient License fee – License fee – Fee per patient – Includes second wave mailings, reporting (comments) data support, guarantee CMS compliance, dedicated customer service Example Example – 1 agency (CCN) with 1000 patients per year – $500 (Base Fee) – $3 per patient Total Cost: $500 + ($3 * 1000) = $ 3,500

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

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SLIDE 41

Pr ic ing Mode ls

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

– 1000 patients – $500 base fee $2 45 per survey and 80% second wave mailing – $2.45 per survey and 80% second wave mailing

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

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

$ ( $ ) ( $ )

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SLIDE 42

Pr ic ing Mode ls

Compliance Pricing

Pricing per provider number – Pricing per provider number – All Inclusive of second wave mailings – Based on number of patients p – Billed up front for the year or monthly at your request – Contract term 24 months

Annual Patients Surveyed Standard Annual Fee HCAF 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

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

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SLIDE 43

Age nc y Pre par ation T ips g y p p

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

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SLIDE 44

Age nc y Pr e par ation T ips

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

L h ll ith ti t – Language challenges with patient

  • Familiarize with HHCAHPS questions
  • Set and review satisfaction goals

Set and review satisfaction goals – Locations – Teams – Disciplines – Timeframes

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

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SLIDE 45

Age nc y Pr e par ation T ips

  • Teach and foster customer centric approach

pp – Develop service training programs

  • Tie customer centric behaviors to performance

– Goals, Incentives, Evaluations – Feedback O – Orientation

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

– Multi disciplined

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

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SLIDE 46

Age nc y Pr e par ation T ips

  • Build HHCAHPS survey into orientation and training

y g

  • Identify improvement initiatives and revise systems
  • Update admissions information

– Advise patient to expect survey – Build pro-active partnership with patient “ ” f – “Tell Me” if my care is not exceeding expectations

  • Exceptional clinical notation of communication

issues issues – Helps set expectations for all visits

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

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SLIDE 47

Additional Resources

  • 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

p gp g p p

  • NQF Endorsement of New Quality and Patient Experience

Standards in Home Health Care

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

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

  • Agency for Healthcare Research Quality

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

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

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SLIDE 48

T hanks for L iste ning!!!

Got Questions – Want Clarification – Need Vendor Got Questions Want Clarification Need Vendor

Bill Bassett Bill Bassett Vice President, Home Health Care e: bbassett@deyta.com 206 910 0428 p: 206.910.0428

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