Home Health Quality Measures
Working with the Centers for Medicare and Medicaid (CMS), the Agency
for Healthcare Research and Quality (AHRQ) convened a meeting of a
technical expert panel on the subject of "Home Health Quality of Care
Measures" on October 21 and 22, 2002 at their headquarters in
Rockville, MD. The goal of this particular CMS effort was to select
measures for its upcoming home health public reporting initiative. A
pilot of this future home health initiative is scheduled to begin
during the spring of 2003. This project was conceived by CMS in July
2002, after the successful completion of a related pilot project for
publicly reporting quality measures for nursing homes. The meeting
served to formally launch this project and to provide a public forum to
hear the technical overview, discussion of pilot background, context,
measurement review criteria and review process for this initiative.
George Taler, MD, CMD of Washington, D.C., and member of the AMDA Home
Health Subsection, attended the meeting representing AMDA and
participated in the public comment period at the conclusion of the
forum.
The nursing home quality measurement and public reporting project
uses data collected from the CMS national database, the Minimum Data
Set (MDS). Quality measures derived from the MDS were tested for
validity and reliability and used in the six-state pilot with selected
nursing homes in Colorado, Florida, Maryland, Ohio, Rhode Island, and
Washington. The quality measures being used for nursing homes are: (1)
late-loss ADL worsening (2) pressure ulcers (3) pressure ulcers with
facility admission profile (FAP) (4) residents with pain (5) physical
restraints used daily (6) infections (7) failure to improve and manage
delirium in short-stay residents (8) failure to improve and manage
delirium in short-stay residents with FAP (9) short stay residents with
pain and (10) short-stay residents with improvement in walking with
FAP. This nursing home initiative will be rolled out nationally on
November 12-13, 2002.
The home health quality measurement and public reporting project
will use data collected from the CMS national database, the Outcome and
Assessment Information Set (OASIS). This meeting dealt with the
preliminary issues for using OASIS data in outcome and quality
improvement projects. Barbara Paul, MD, CMS Director of Quality
Measurement and Health Assessment Group, gave a presentation on CMS
Public Reporting Activities and Ed Kelly of AHRQ gave a presentation on
the National Healthcare Quality Report. There were also presentations
on consumer and Fiscal Intermediary response to OASIS and an in-depth
look at OASIS properties. The meeting focused on reviews of OASIS
Domains (Getting Better, Living with Disability and Staying
Healthy/Avoiding Injury) and on addressing the prioritization of
measures for this project.
To view updates or monthly Open Door Forum schedules, visit www.cms.gov/opendoor/schedule.asp.
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