Presentation Slides
8/17/2016
Home Health Value Based Purchasing Session 6: Interim Performance Reports (IPR)
HHVBP Sessions • Session 6: Interim Performance Reports (today) • Previous session topics: – Overview – New Measures & KAHL Modules – Total Performance Score and Baseline Reports – Requesting Access to the Secure Portal – HHVBP Frequently Asked Questions • Future session topics: – Changes to the ACP/Shingles form and report in KL
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8/17/2016
Today’s Session • Prior to today’s session, you should have: • Obtained access to the HHVBP Secure Portal as Secondary Point of Contact – If you have not, access the recording and resource materials for Session 4: Requesting Access to the Secure Portal on the HH PI webpages and KAH Learning (Course # PI1007WCR)
• In today’s session, we will cover the following: • How to access Interim Performance Reports (IPR) via the HHVBP Secure Portal • How to review and interpret the information contained in the IPR. 3
Accessing the HHVBP Secure Portal
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8/17/2016
Home Screen Notifications Show or Hide
Dismiss
Tip: Hide and show your notifications by clicking on the arrow next to the Bell icon in the upper right of your screen
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Home Screen Tabs 8
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8/17/2016
Reports Tab Access available Interim Performance Reports and Annual Total Performance Score & Payment Adjustment Reports
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Interim Reports
Select a report using this drop-down menu. Your first report will be listed under July 2016.
Note: If an IPR report does not exist for a selected time period, you will receive an error message. 8
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8/17/2016
Downloading the IPR
Once report is selected, use this button to download the report in Microsoft Excel format.
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Your HHA Will Have an IPR If… • Your HHA was “active” at some point during both the Performance and Baseline Years • Your HHA had at least one available measure (at least 20 cases) in both the Performance Year and Baseline Year • •
For the July Report, Performance Year data is only available for the OASIS-based measures due to lags in the availability of claims and HHCAHPS measures. You will see zeros for your claims and HHCAHPS measures, but they are not included in the TPS.
• Your HHA will have a TPS calculated if you have at least 5 measures available in both the Performance Year and Baseline Year. • The TPS calculation requires Performance Year data, so only OASISbased measures are used for the July report. • IPR’s include information for the entire Medicare provider number, not split out by individual branches 10
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8/17/2016
Purpose of the IPR • Provides HHAs with their individual Baseline Period Score (CY 2015) and their final cohort Baseline Period Achievement Thresholds and Benchmarks • These will be used throughout the HHVBP demonstration • Provides quarterly feedback to the HHA concerning current performance relative to Achievement Thresholds and Benchmarks • Allows the HHA to see the contribution of each quality measure to the Total Performance Score (TPS) • Assists the HHA with identifying where performance improvement would have an effect on the TPS and payment
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IPR Timeline: Performance Year 1* Report Release Date
Performance Score Periods Reported OASIS-Based Measures
Claims-Based/ HHCAHPS-Based Measures ---
New Measures Submission Points
July 2016
12 months ending 3/31/2016
Sample Points
October 2016
12 months ending 6/30/2016
12 months ending 3/31/2016
Sample Points
January 2017
12 months ending 9/30/2016
12 months ending 6/30/2016
Quarter ending 9/30/2016
April 2017
12 months ending 12/31/2016
12 months ending 9/30/2016
Quarter ending 12/31/2017
July 2017
12 months ending 3/31/2017
12 months ending 12/31/2016
Quarter ending 3/31/2017
*Also a handout attached with the presentation materials. 12
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8/17/2016
IPR Definitions*
*Also a handout attached with the presentation materials. 13
Interim Performance Report Displays report dates and your HHA information. Reminder: The IPR includes data for the entire CCN
Includes 5 tabs (located at the bottom of the Excel window): • Achievement • Improvement • Care Points • New Measures • TPS 14
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8/17/2016
Achievement Points Tab Remember This! No achievement points are awarded if performance is less than achievement threshold. Data Period 12 Month Ending: This is the last date of data included in the HHA Performance Score. So the first IPR includes OASIS 4/1/15 – 3/31/16 and claims/HHCAHPS 1/1/15 – 12/31/15 data for the HHA Performance Score. HHA Performance Score: Your CCN’s score for the report time period. Achievement Threshold: The median score of HHA’s in your state and cohort for the baseline period (CY 2015). This will stay the same the entire demonstration. Benchmark: The mean of the top 10% of HHAs in your state and cohort for the baseline period (CY 2015). This will stay the same the entire demonstration. Current Achievement Points*: Based on the Achievement Point Calculation, the amount of achievement points your HHA earned. *See Session 3: Total Performance Score and Baseline Reports (PI1006WCR) for a refresher on VBP scoring.
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Missing / Data Not Available Remember This! Whenever data is not available, an asterisk is displayed and the measure is not used in TPS calculation
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8/17/2016
Achievement Points For OASIS Measures: • Achievement points are awarded if performance is better than the threshold. For HHCAHPS Measures: • Achievement points are awarded if performance is better than the threshold.
Note: There must be 2016 year data to generate a Performance Score. For the first IPR, claims and HHCAHPS measures will have zeros. This does not count against the HHA.
For the Claims-Based Measures: • Achievement points are awarded when the numerical value of the measure is lower than the threshold. 17
Improvement Points Tab Remember This!
Performance year period overlaps baseline period for the first three IPRs. 22
Data Period 12 Month Ending: This is the last date of data included in the HHA Performance Score. So the first IPR includes OASIS 4/1/15 – 3/31/16 and claims/HHCAHPS 1/1/15 – 12/31/15 data for the HHA Performance Score. HHA Performance Score: Your CCN’s score for the report time period. Baseline Period Score: This is your individual HHA’s baseline score for CY 2015. This will be used throughout the entire demonstration and you need to score higher than this number to earn improvement points. Benchmark: The mean of the top 10% of HHAs in your state and cohort for the baseline period (CY 2015). This will stay the same the entire demonstration. Current Improvement Points*: Based on the Improvement Point Calculation, the amount of improvement points your HHA earned. *See Session 3: Total Performance Score and Baseline Reports (PI1006WCR) for a refresher on VBP scoring.
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8/17/2016
Baseline Year Data Template* Steps: 1. One page for each of the 9 HHVBP states 2. Find the page with your state 3. Determine if your HHA is in the large or small cohort
Large = 60+ beneficiaries in a calendar year Small = 59 or fewer beneficiaries in a calendar year; small cohort HHAs will not have CAHPS data (section will be blank)
4. Complete the highlighted sections
Individual CCN baseline year data is on the Improvement tab in your July 2016 IPR: “Baseline Period Score” (Column D)
5. Print and use as a reference for your VBP goals Note: • Look at the “Status” field to see if the data is Final or Preliminary Final time period: All measures CY 2015 Preliminary time period: OASIS CY 2015; Claims/CAHPS 1/14-9/15 *Also a handout attached with the presentation materials.
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Improvement Points For OASIS Measures: • Improvement points are awarded if performance is better than the baseline period score. For HHCAHPS Measures: • Improvement points are awarded if performance is better than the baseline period score.
Note: There must be 2016 year data to generate a Performance Score. For the first IPR, claims and HHCAHPS measures will have zeros. This does not count against the HHA.
For the Claims-Based Measures: • Improvement points are awarded if performance is lower than the baseline period score. 20
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8/17/2016
Care Points Tab
Sufficient Data for Measure Inclusion: Your HHA must have a minimum of 20 episodes of care to be scored
Current Care Points: The higher of the Current Achievement Points (from the Achievement tab) or the Current Improvement Points (from the Improvement tab) 21
New Measures Tab Remember This!
This is sample data. Actual New Measure data will first be available in the Jan 2017 IPR. Available Points: The points received for reporting the measure (10 points = reported, 0 points = not reported) Measures Reported (MR) : The count of new measures reported to CMS New Measure Points*: The total New Measure Points *See Session 3: Total Performance Score and Baseline Reports (PI1006WCR) for a refresher on VBP scoring. 22
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8/17/2016
Total Performance Score Tab For a refresher on the TPS calculation, you can view Session 3: Total Performance Score and Baseline Reports (PI1006WCR) in KAH Learning
Remember This! The TPS is what CMS will use to rank your HHA against other HHA’s and determine payment adjustment.
What Numbers to Focus On? 1. Total Applicable Measure Points: This number summarizes your score on your available OASIS, claims, and HHCAHPS measures out of 100 possible points. 2. Total New Measure Points: This number summarizes your score on your new measures out of 100 possible points. 3. Total Performance Score: This number summarizes your overall performance on the OASIS, claims, HHCAHPS, and new measure for HHVBP out of 100 possible points 23
Interpreting Performance Reports • IPRs should be used as tool towards quality improvement. Aim to see improvement in scores from report to report. • Also use SHP to track your quality improvement for the VBP measures. • Remember that the early IPRs will have limited room for improvement, but later reports may show an increase in improvement scores. • Look for opportunities for quality improvement. • Incorporate quality improvement into all of your data monitoring activities. 24
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8/17/2016
Recalculation Request • Recalculation requests provide HHAs with the opportunity to identify and correct calculation errors and resolve discrepancies prior to receiving their Annual TPS and Payment Adjustment Report • If an HHA has proof of an error, it may request a recalculation of performance scores within 30 days of when CMS publishes the report to the HHVBP Secure Portal • The requester must submit documentation supporting the request • One recalculation request per report • Will be handled at the division level, not the branch/local level
Remember This! Submission of inaccurate OASIS data is not an acceptable justification for a recalculation request, as OASIS data accuracy is a Condition of Participation (42 CFR §484.20).
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CMS Future Plans • CMS has stated they intend to: – Inform HHAS of how they rank against each other – Provide more information about the Total Performance Score – Provide additional information on the payment adjustment calculation
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13
8/17/2016
HHVBP Sessions • Information related to VBP will be distributed via the KAH HH Value Based Purchasing email distribution list • HHVBP educational sessions are recorded and made available through Kindred at Home Learning • Future session topics: – Changes to the ACP/Shingles form and report in KL • Please email your questions to the Clinical Practice and Quality Team ̶ [email protected]
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More Information • CMS Home Health Value Based Purchasing Site: – –
https://innovation.cms.gov/initiatives/home-health-value-based-purchasing-model Contact the HHVBP Help Desk at [email protected] OR 1-844- 280-5628
• Resources: – – – – –
Frequently Asked Questions (updated) Accessing the Secure Portal and Interim Performance Report Job Aid HHVBP Interim Performance Report Timeline Year 1 HHVBP Interim Performance Reports Definitions HHVBP Baseline Year Data Template
• KAH Division HH Clinical Practice & Quality Team: – – – – –
Judy Fenton, VP Clinical Practice and Quality; [email protected] Cyndi Shook, Director Quality and Performance Improvement; [email protected] Oneika Webb, Director Quality and Performance Improvement; [email protected] Amy O’Brien, Clinical Project Manager; [email protected] Matt Janes, Director, Therapy Practice and Quality; [email protected]
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Home Health Value Based Purchasing Session 6: Interim Performance Reports (IPR)
HHVBP Sessions • Session 6: Interim Performance Reports (today) • Previous session topics: – Overview – New Measures & KAHL Modules – Total Performance Score and Baseline Reports – Requesting Access to the Secure Portal – HHVBP Frequently Asked Questions • Future session topics: – Changes to the ACP/Shingles form and report in KL
2
1
8/17/2016
Today’s Session • Prior to today’s session, you should have: • Obtained access to the HHVBP Secure Portal as Secondary Point of Contact – If you have not, access the recording and resource materials for Session 4: Requesting Access to the Secure Portal on the HH PI webpages and KAH Learning (Course # PI1007WCR)
• In today’s session, we will cover the following: • How to access Interim Performance Reports (IPR) via the HHVBP Secure Portal • How to review and interpret the information contained in the IPR. 3
Accessing the HHVBP Secure Portal
4
2
8/17/2016
Home Screen Notifications Show or Hide
Dismiss
Tip: Hide and show your notifications by clicking on the arrow next to the Bell icon in the upper right of your screen
5
Home Screen Tabs 8
6
3
8/17/2016
Reports Tab Access available Interim Performance Reports and Annual Total Performance Score & Payment Adjustment Reports
7
Interim Reports
Select a report using this drop-down menu. Your first report will be listed under July 2016.
Note: If an IPR report does not exist for a selected time period, you will receive an error message. 8
4
8/17/2016
Downloading the IPR
Once report is selected, use this button to download the report in Microsoft Excel format.
9
Your HHA Will Have an IPR If… • Your HHA was “active” at some point during both the Performance and Baseline Years • Your HHA had at least one available measure (at least 20 cases) in both the Performance Year and Baseline Year • •
For the July Report, Performance Year data is only available for the OASIS-based measures due to lags in the availability of claims and HHCAHPS measures. You will see zeros for your claims and HHCAHPS measures, but they are not included in the TPS.
• Your HHA will have a TPS calculated if you have at least 5 measures available in both the Performance Year and Baseline Year. • The TPS calculation requires Performance Year data, so only OASISbased measures are used for the July report. • IPR’s include information for the entire Medicare provider number, not split out by individual branches 10
5
8/17/2016
Purpose of the IPR • Provides HHAs with their individual Baseline Period Score (CY 2015) and their final cohort Baseline Period Achievement Thresholds and Benchmarks • These will be used throughout the HHVBP demonstration • Provides quarterly feedback to the HHA concerning current performance relative to Achievement Thresholds and Benchmarks • Allows the HHA to see the contribution of each quality measure to the Total Performance Score (TPS) • Assists the HHA with identifying where performance improvement would have an effect on the TPS and payment
11
IPR Timeline: Performance Year 1* Report Release Date
Performance Score Periods Reported OASIS-Based Measures
Claims-Based/ HHCAHPS-Based Measures ---
New Measures Submission Points
July 2016
12 months ending 3/31/2016
Sample Points
October 2016
12 months ending 6/30/2016
12 months ending 3/31/2016
Sample Points
January 2017
12 months ending 9/30/2016
12 months ending 6/30/2016
Quarter ending 9/30/2016
April 2017
12 months ending 12/31/2016
12 months ending 9/30/2016
Quarter ending 12/31/2017
July 2017
12 months ending 3/31/2017
12 months ending 12/31/2016
Quarter ending 3/31/2017
*Also a handout attached with the presentation materials. 12
6
8/17/2016
IPR Definitions*
*Also a handout attached with the presentation materials. 13
Interim Performance Report Displays report dates and your HHA information. Reminder: The IPR includes data for the entire CCN
Includes 5 tabs (located at the bottom of the Excel window): • Achievement • Improvement • Care Points • New Measures • TPS 14
7
8/17/2016
Achievement Points Tab Remember This! No achievement points are awarded if performance is less than achievement threshold. Data Period 12 Month Ending: This is the last date of data included in the HHA Performance Score. So the first IPR includes OASIS 4/1/15 – 3/31/16 and claims/HHCAHPS 1/1/15 – 12/31/15 data for the HHA Performance Score. HHA Performance Score: Your CCN’s score for the report time period. Achievement Threshold: The median score of HHA’s in your state and cohort for the baseline period (CY 2015). This will stay the same the entire demonstration. Benchmark: The mean of the top 10% of HHAs in your state and cohort for the baseline period (CY 2015). This will stay the same the entire demonstration. Current Achievement Points*: Based on the Achievement Point Calculation, the amount of achievement points your HHA earned. *See Session 3: Total Performance Score and Baseline Reports (PI1006WCR) for a refresher on VBP scoring.
15
Missing / Data Not Available Remember This! Whenever data is not available, an asterisk is displayed and the measure is not used in TPS calculation
16
8
8/17/2016
Achievement Points For OASIS Measures: • Achievement points are awarded if performance is better than the threshold. For HHCAHPS Measures: • Achievement points are awarded if performance is better than the threshold.
Note: There must be 2016 year data to generate a Performance Score. For the first IPR, claims and HHCAHPS measures will have zeros. This does not count against the HHA.
For the Claims-Based Measures: • Achievement points are awarded when the numerical value of the measure is lower than the threshold. 17
Improvement Points Tab Remember This!
Performance year period overlaps baseline period for the first three IPRs. 22
Data Period 12 Month Ending: This is the last date of data included in the HHA Performance Score. So the first IPR includes OASIS 4/1/15 – 3/31/16 and claims/HHCAHPS 1/1/15 – 12/31/15 data for the HHA Performance Score. HHA Performance Score: Your CCN’s score for the report time period. Baseline Period Score: This is your individual HHA’s baseline score for CY 2015. This will be used throughout the entire demonstration and you need to score higher than this number to earn improvement points. Benchmark: The mean of the top 10% of HHAs in your state and cohort for the baseline period (CY 2015). This will stay the same the entire demonstration. Current Improvement Points*: Based on the Improvement Point Calculation, the amount of improvement points your HHA earned. *See Session 3: Total Performance Score and Baseline Reports (PI1006WCR) for a refresher on VBP scoring.
18
9
8/17/2016
Baseline Year Data Template* Steps: 1. One page for each of the 9 HHVBP states 2. Find the page with your state 3. Determine if your HHA is in the large or small cohort
Large = 60+ beneficiaries in a calendar year Small = 59 or fewer beneficiaries in a calendar year; small cohort HHAs will not have CAHPS data (section will be blank)
4. Complete the highlighted sections
Individual CCN baseline year data is on the Improvement tab in your July 2016 IPR: “Baseline Period Score” (Column D)
5. Print and use as a reference for your VBP goals Note: • Look at the “Status” field to see if the data is Final or Preliminary Final time period: All measures CY 2015 Preliminary time period: OASIS CY 2015; Claims/CAHPS 1/14-9/15 *Also a handout attached with the presentation materials.
19
Improvement Points For OASIS Measures: • Improvement points are awarded if performance is better than the baseline period score. For HHCAHPS Measures: • Improvement points are awarded if performance is better than the baseline period score.
Note: There must be 2016 year data to generate a Performance Score. For the first IPR, claims and HHCAHPS measures will have zeros. This does not count against the HHA.
For the Claims-Based Measures: • Improvement points are awarded if performance is lower than the baseline period score. 20
10
8/17/2016
Care Points Tab
Sufficient Data for Measure Inclusion: Your HHA must have a minimum of 20 episodes of care to be scored
Current Care Points: The higher of the Current Achievement Points (from the Achievement tab) or the Current Improvement Points (from the Improvement tab) 21
New Measures Tab Remember This!
This is sample data. Actual New Measure data will first be available in the Jan 2017 IPR. Available Points: The points received for reporting the measure (10 points = reported, 0 points = not reported) Measures Reported (MR) : The count of new measures reported to CMS New Measure Points*: The total New Measure Points *See Session 3: Total Performance Score and Baseline Reports (PI1006WCR) for a refresher on VBP scoring. 22
11
8/17/2016
Total Performance Score Tab For a refresher on the TPS calculation, you can view Session 3: Total Performance Score and Baseline Reports (PI1006WCR) in KAH Learning
Remember This! The TPS is what CMS will use to rank your HHA against other HHA’s and determine payment adjustment.
What Numbers to Focus On? 1. Total Applicable Measure Points: This number summarizes your score on your available OASIS, claims, and HHCAHPS measures out of 100 possible points. 2. Total New Measure Points: This number summarizes your score on your new measures out of 100 possible points. 3. Total Performance Score: This number summarizes your overall performance on the OASIS, claims, HHCAHPS, and new measure for HHVBP out of 100 possible points 23
Interpreting Performance Reports • IPRs should be used as tool towards quality improvement. Aim to see improvement in scores from report to report. • Also use SHP to track your quality improvement for the VBP measures. • Remember that the early IPRs will have limited room for improvement, but later reports may show an increase in improvement scores. • Look for opportunities for quality improvement. • Incorporate quality improvement into all of your data monitoring activities. 24
12
8/17/2016
Recalculation Request • Recalculation requests provide HHAs with the opportunity to identify and correct calculation errors and resolve discrepancies prior to receiving their Annual TPS and Payment Adjustment Report • If an HHA has proof of an error, it may request a recalculation of performance scores within 30 days of when CMS publishes the report to the HHVBP Secure Portal • The requester must submit documentation supporting the request • One recalculation request per report • Will be handled at the division level, not the branch/local level
Remember This! Submission of inaccurate OASIS data is not an acceptable justification for a recalculation request, as OASIS data accuracy is a Condition of Participation (42 CFR §484.20).
31
25
CMS Future Plans • CMS has stated they intend to: – Inform HHAS of how they rank against each other – Provide more information about the Total Performance Score – Provide additional information on the payment adjustment calculation
26
13
8/17/2016
HHVBP Sessions • Information related to VBP will be distributed via the KAH HH Value Based Purchasing email distribution list • HHVBP educational sessions are recorded and made available through Kindred at Home Learning • Future session topics: – Changes to the ACP/Shingles form and report in KL • Please email your questions to the Clinical Practice and Quality Team ̶ [email protected]
27
More Information • CMS Home Health Value Based Purchasing Site: – –
https://innovation.cms.gov/initiatives/home-health-value-based-purchasing-model Contact the HHVBP Help Desk at [email protected] OR 1-844- 280-5628
• Resources: – – – – –
Frequently Asked Questions (updated) Accessing the Secure Portal and Interim Performance Report Job Aid HHVBP Interim Performance Report Timeline Year 1 HHVBP Interim Performance Reports Definitions HHVBP Baseline Year Data Template
• KAH Division HH Clinical Practice & Quality Team: – – – – –
Judy Fenton, VP Clinical Practice and Quality; [email protected] Cyndi Shook, Director Quality and Performance Improvement; [email protected] Oneika Webb, Director Quality and Performance Improvement; [email protected] Amy O’Brien, Clinical Project Manager; [email protected] Matt Janes, Director, Therapy Practice and Quality; [email protected]
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