The Benchmark Email

...benchmarks, strategies and ideas for improving your agency
A service of Fazzi Associates, Inc.

October 3, 2005

High Quality Scores and P4P

Question:
We are becoming more and more concerned about pay-for-performance (P4P) and what it will mean to our agency. We have heard that agencies that have high quality scores, i.e. top 10%, might be in line for bonuses.  Do we know which of the Home Health Compare measures will be used and what level of scores the top 10% will need to achieve? Can agencies really impact these scores?

Answer:
At this stage, we do not know which of the home health quality measures will be used by CMS.  On September 1, 2005, CMS released a new set of Home Health Compare measures.  The measures went from eleven to ten and included many of the measures that were previously reported.  Three new measures were added:  Improvement in Dyspnea, Improvement in Urinary Incontinence and Discharged to Community.  While we do not know what outcome measures will be used in a P4P model, it is likely that acute care hospitalization will be included among other outcome measures that promote preventative care.

The Fazzi Associates research division has identified the score an agency would need in order to be in the top 10% of each outcome measure. The results of this analysis are found in the table below.
 

©2005 Fazzi Associates, Inc. 

Can these scores be impacted?  The answer is absolutely YES.  There are excellent tools now available.  Many IS systems include quality measures that help agencies verify the accuracy of OASIS responses.  Agencies have implemented new quality improvement efforts.  Quality audits, trainings and programs like Fazzi's new P4P Quality Program provide agencies with the ability to approach improvement on a holistic basis rather than a silo basis.

What is clear is that P4P is coming. We know how to identify what scores top performers need to achieve.  And, we have the capacity and the support systems to help agencies prepare now for P4P.