visit freq figured into Medicare OUTCOMES?

renerian, BSN, RN · Jun 25, 2005

I am trying to figure out if you mean outcomes as in Home Health Compare, OASIS reports, or if you are looking for some type of case mix profile to identify a common frequency? I need to clarify to assist you.

renerian

Traveler · Jun 25, 2005

I may not be understanding your question correctly and, if not, I apologize. I believe that the way Medicare comes up with the outcome data is from any changes in the status of the patient from admission to recert or discharge. Things that they look at are changes in functional status, continence, pain, etc. Also tracked is if the patient has utilized and emergency treatment or hospitalizations.

becca-roo · Jun 26, 2005

I am trying to figure out if you mean outcomes as in Home Health Compare, OASIS reports, or if you are looking for some type of case mix profile to identify a common frequency? I need to clarify to assist you.
renerian

I refer to Outcome results from OASIS data collection that compare agencies...do the freq of visits have any bearing on these instances?

renerian, BSN, RN · Jun 26, 2005

Basically an agency can use carepaths to guide care hoping, maybe they can move a patient through the system in a uniform manner which does not always work. An agency can manage their care, frequency within their RAP/Final bill and make money or lose money based on the patient outcomes, resources and things of that nature. Is that what your meaning?

Or are you looking for the data related to inital studies related to the OASIS inital projects?

renerian

Home Health Columnist / Guide · Jul 3, 2005

oasis comparison you are referring to compares patient at admission and then at discharge. number of visits not singulary factored in as info is multiplied from all admissions /discharges an agency has within a time interval.

see cms website:

http://www.cms.hhs.gov/quality/hhqi/

the risk-adjusted outcome reports provided for home health agency outcome-based quality improvement includes, for each outcome measure, the agency's observed outcome rate and a risk-adjusted national reference rate. the national reference rate is calculated based on the case mix of the agency's patients, using statistical models estimated on a national sample of home health agency patients. the method used to calculate the national reference rate is as follows:

for each home health agency patient to whom a particular outcome measure applies, a predicted outcome probability is calculated, based on the patient's health status and other attributes at admission to home health care.
predicted outcome probabilities are averaged across all of the agency's current patients to yield a predicted outcome rate, which is displayed as the national (risk-adjusted) reference rate for that agency. this current predicted outcome rate can be interpreted as the outcome rate that patients in the national sample would have experienced if they had the same case mix as the patients served by that particular agency.

this method of calculating a risk adjusted reference rate for home health agencies appropriately takes into account variations between agencies in patient case mix, and it provides a means for all agencies to measure their outcomes against a national, risk-adjusted standard. http://www.cms.hhs.gov/oasis/obqi.asp

might be able to find some info here from quality insights of pa :

http://www.qipa.org/medprohomehealth.asp

quality insights offers process improvement tools and training to all pennsylvania home health agencies

the summer 2005 issue of home health insights is complete. you may access on our website: http://www.qipa.org/medpronewshome.asp