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Transforming Home Healthcare – 8 th Scope of Work . LT David Dietz Task 1b Government Task Leader February 16 – Chester River Home Health and Hospice visit Meeting the needs of HHAs Structure/focus of visits Timeliness Processes/systems that fit their needs

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transforming home healthcare 8 th scope of work

Transforming Home Healthcare – 8th Scope of Work

LT David Dietz

Task 1b Government Task Leader

February 16 – Chester River Home Health and Hospice visit
  • Meeting the needs of HHAs
    • Structure/focus of visits
    • Timeliness
    • Processes/systems that fit their needs
    • Data/results
transformational change
Transformational Change
  • Change which enables an HHA to deliver care meeting the goals of safety, effectiveness, efficiency, timeliness, patient-centeredness and equity
  • Results from the implementation of 4 strategies:
    • Measure and report performance
    • Adopt HIT and use it effectively
    • Redesign care process
    • Transform organizational culture
home health quality improvement priorities for 8 th sow possibly
Home Health Quality Improvement Priorities for 8th SoW - Possibly
  • Achieve specified reduction in failure rates for acute hospitalization (IPs and statewide)
  • Achieve specified reduction in failure rates for the publicly reported OASIS measures (IPs and statewide)
  • Achieve a specified improvement rate for immunization assessment (statewide)
  • Implement and utilize telehealth
effective use of resources
Effective Use of Resources
  • Maximize available resources (e.g., MedQIC, QIOSC, collaboration with other Task 1 sub-tasks)
  • Share resources within the QIO community – this is a national program, not a state one
  • Integrate communications and consistent program messages
  • Share learning and promote successes – this is a national program, not a state one
acute care hospitalization possibly
Acute Care Hospitalization - Possibly
  • Based on 23% best attainable rate (75th percentile of 7th SoW Round 1 IPs)
  • 50% Reduction in failure rate for IPs (e.g., 27% - 25%)
  • 30% Reduction in failure rate for statewide
  • IPs must work with this measure
  • This is also a mandatory statewide measure
  • If a state has a rate less than or equal to 23%, they may develop their own plan for reducing acute care hospitalization (to be approved by PO and GTL)
publicly reported oasis measures possibly
Publicly Reported OASIS Measures - Possibly
  • Target reduction in failure rates, based on 75th percentile of 7th SoW Round 1 IPs
  • Target reduction in failure rates based on 90% best attainable rate (100% for status of surgical wounds)
  • If the performance for the QIO’s state/jurisdiction for statewide work or IP work is greater than or equal to 90% (minus acute care and status of surgical wounds, the QIO shall work on a different measure)
  • IPs will work on one of their choosing; regarding the statewide, the QIO will choose the measure
  • Emergent care is excluded
statewide immunization work possibly
Statewide Immunization Work - Possibly
  • Goal: to incorporate influenza and pneumococcal immunizations into HHAs comprehensive patient assessments
  • Two surveys conducted – Sept 2006, the other measuring improvement, Nov 2007
  • Goal: to achieve a 50% improvement from baseline to remeasurement, measuring the percent of HHAs that have incorporated these immunizations into their comprehensive patient assessment, including offering these vaccinations as well as providing follow-up consultation if necessary
telehealth ip specifics possibly
Telehealth IP Specifics - Possibly
  • Implement or utilize telehealth as a tool to reduce acute care hospitalization
  • May include telemedicine (i.e., audio consultation, phone messages) or telemonitoring (i.e., audio/video/data consultation)
  • Shall meet CMS Telehomecare Clinical Guidelines (developed by Quality Insight of PA), to be released summer of 2005
  • Evaluation would include both an implementation and acute care hospitalization component (greater RFR than non-telehealth IPs)
ip hha size requirements possibly
IP HHA Size Requirements - Possibly
  • HHA size based on OBQI reports
  • Small HHAs – less than 90 episodes annually
  • Medium HHAs – 91-350 episodes annually
  • Large HHAs – 351+ episodes annually
  • Minimum requirements:
    • 10% Small HHAs
    • 10% Medium HHAs
    • 15% Large HHAs

*If a state/jurisdiction is unable to meet these requirements, it must demonstrate so to both the PO and GTL

substitution clause possibly
Substitution Clause - Possibly
  • The QIO may select up to 10 additional HHAs to work with on identified participant activities. The QIO may substitute 1 or more of these 10 HHAs at the time of evaluation only if a) an IP has gone out of business, or b) changed ownership (changes based on PRS )
8th scope of work qiosc competition
8th Scope of Work – QIOSC Competition
  • Scope of work is completed, request for proposals soon to follow
  • Open competition to all
  • Consider your resources before you submit a technical proposal……
  • Consider your reasons before you submit a technical proposal……
the 4 qio commandments
The 4 QIO Commandments
  • We live and die by the numbers
  • We must constantly report quantitative estimates of our activities and accomplishments
  • We must demonstrate performance difference between identified participants and statewide
  • We must enjoy and like to do this!
7 th scope of work rounds 1 and 2
7th Scope of Work, Rounds 1 and 2
  • 36 Total states rounds 1 and 2
  • 22 States scored .95 or better
  • 14 States did not reach .95 !!!!
how do we prove qio program is effective
How Do We Prove QIO Program is Effective?
  • Identified participant performance based on NUMBERS
  • Direct correlation between QIO efforts and positive improvement in the data
how do we prove qios are efficient
How Do We Prove QIOs Are Efficient?
  • Shared resources developed by QIOSC
  • Less duplication in efforts
  • Shared learning = shared success stories
  • National improvement