The introduction of Home Health Value Based Purchasing has brought increasing scrutiny on the quality of care provided by home health agencies, leading agencies to focus on the components being used to define quality.  The impact of the individual measures that contribute to an agency’s Total Performance Score (TPS) in Value Based Purchasing (VBP) may not appear to have a significant bearing on the agencies reimbursement. However when the measures are viewed within the groupings that the Centers for Medicare and Medicaid Services (CMS) has established, the impact of the groups can be substantial.

The Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) is such an example, providing 30% of the TPS through the Person & Caregiver Centered Experience domain of the VBP model.  Learning how to improve in the four HHCAHPS categories will improve the overall score of an agency for not only VBP, but also their scores on Home Health Compare, and their star ratings.

The HHCAHPS survey comprises 32 questions (questionnaire can be downloaded here), which are grouped into three composite questions, and two global questions.

Understanding the questions in both the composite and global scores provides greater context and understanding, making it easier to target agency improvements.

Here are a few common questions asked regarding how the survey can be communicated to patients:

• Are the questions asked on the Home Health CAHPS survey reviewed with a patient?
• Is a copy provided to the patient?
• Can the patient be informed to provide a positive rating when completing the survey?

To answer these questions, we must understand that the patient population surveyed is considered “vulnerable,” and can only be notified by the agency during start of care and on recertification. Because of this, the answer to all of the above questions is no. Additional information regarding acceptable communication can be found in the Home Health Care CAHPS® Survey Protocols and Guidelines Manual, version 8, pages 15 and 16.

In this series, we will review strategies for improving the Home Health CAHPS individual composite scores, and the global scores collectively. The opportunity to work collaboratively with agency staff to create a care experience that is special will ensure your long-term success with Home Health VBP.