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Quality of Patient Care Star Rating Algorithm for Home Health Agencies – Final Modifications

At a Medicare Learning Network (MLN) Event on October 3 2018, CMS presented the rationale, timing, and impact of modifications to the Quality of Patient Care Star (QoPC) Rating for Home Health Agencies (HHAs).

  1. The removal from the QoPC Star Ratings the measure “Drug Education on all Medications Provided to Patient/Caregiver.”
    • The decision to remove this measure is based on the rationale that the measure was no longer meaningful in comparing across HHAs.
  2. The addition to the QoPC Star Ratings the measure “Improvement in Management of Oral Medications” which is currently reported on Home Health Compare:
    • Rationale for Adding “Improvement in Management of Oral Medications”: This measure is risk-adjusted using a rich set of risk factors from the OASIS, including living arrangement.
    • Risk adjusted performance shows no difference between HHAs serving high or low proportions of patients living in a congregate setting.
    • Medication management is an important clinical area of home health care.
    • As fewer measures are included in the calculation, the QoPC Star Rating becomes less representative of overall home health quality. Including this measure maintains the number of component measures at 8 (after the removal of the “Drug Education on All Medications Provided to Patient/Caregiver” measure).

Timeline for Changes to QoPC Star Rating:
First QoPC Star Rating Provider Preview Reports to HHAs using new calculation algorithm is expected to occur in January 2019.

  • Home Health Compare refresh displaying the updated QoPC Star Rating is therefore expected to take place in April 2019.
  • All OASIS-based measures report on data from July 1, 2017 to June 30, 2018.
  • Claims-based measures will report on data from CY2017 (updated annually).

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