Value Based Purchasing
An incentive/penalty reimbursement model that awards/denies points to an HHA based on patients improvement
Value Based Purchasing (VBP)
Which GG0130 items are considered as part of VBP?
GG0130A – Eating,
GG0130B – Oral Hygiene,
GG0130C – Toileting Hygiene
PHHI’s current Patient Experience Star Rating
5 Stars
Which GG0170 items are considered as part of VBP?
GG0170A – Roll right to left, GG0170C – Lying to sitting on the side of the bed, GG0170D – Sit to stand, GG0170E – Chair/bed to chair transfer, GG0170F – Toilet transfer, GG0170I – Walk 10 feet, GG0170J – Walk 50 feet with 2 turns,
Which pay source requires a NOMNC?
Medicare, Medicare Advantage, MSP
The two types of points an agency can earn
Achievement or Improvement
DME is always taken into consideration when scoring GG0130 items. True or False?
False
Patient satisfaction accounts for what overall percentage of VBP?
30%
Which GG0170 item replaces the “walking” tasks for a non-ambulatory patient?
GG0170R – Wheel 50 feet with 2 turns (counts as 2 items)
Time allowed to complete an OASIS or review note based on Performance Standards?
48 hours
The 3 OASIS based measures of VBP
Discharge Function Score, Improvement in Oral Medications, and Improvement in Dyspnea
Name that item: The ability to maintain perineal hygiene, adjust clothes before and after voiding or having a bowel movement. If managing an ostomy, include wiping the opening but not managing equipment.
Toileting hygiene
3 strategies to improve patient satisfaction
Call us first to avoid hospitalization,
arrive timely,
communicate openly with patients and follow up on issues/concerns,
address patients properly,
involve them in their care with education and ensured understanding
Human assistance to complete a task is considered when scoring GG0170 items. True or False?
True
PHHI’s current Outcome Star Rating
4.5 Stars
DM, Falls with injury, CHF, and infections are examples of what?
Potentially Preventable Hospitalizations
What is the six point scoring scale used for GG0130?
Ways patients can show their support, appreciation and satisfaction
Google reviews, like and follow on social media, comment cards in patient folder, tell us their story, How to Make a Gift in patient folder, HHCAHPS survey and return, Circle of Care, Annual Appeal, attend Agency events
If a patient doesn’t have stairs/steps how can you score GG0170 M, N, or O?
Use clinical judgement, 09 is not an acceptable option
What is therapy required to complete every 30 days?
Reassessment
The 5 categories that affect HH-CAHPS points?
Care of Patients, Communications, Specific Care Issues, % of patients who rate 9 or 10, % of patients who would recommend
Can you score an item with a Not Attempted code (07 Refused, 09 Not Applicable, 10 Environmental limitations, 88 Medical or Safety Concerns)
Yes, but CMS will use other assessment data to adjust the response to “fit the patient” based on other characteristics of the same patient population so its best to use clinical judgement to score using the 01-06 scale
10
The rating we want for a job well done!
At SOC, scoring an item “Prior to the benefit of service” means prior to provision of any care by the HHA staff that would result in more independent coding. True or False?
True
The form completed by the physician when a patient lacks capacity and has no advance directives
Healthcare Surrogate