End of the PHE: Revitalize Your QAPI Plans

For home health agencies, 2023 is a significant year—not only is it the first performance year under the new Home Health Value-Based Purchasing (HHVBP) model, but it’s also the end of the Public Health Emergency (PHE) flexibilities.

With the PHE ending on May 11, CMS will again resume its regular Quality Assessment and Performance Improvement (QAPI) requirement for home health agencies after having narrowed the scope to only infection control protocols during the PHE.

To elevate quality and outcomes, stay in compliance, and maximize reimbursements in 2025, it’s time to ensure that your agency has a solid QAPI program in place that will allow you to optimize performance in key assessment areas and set an improved performance-year baseline this year.

To help you revisit and revitalize your QAPI plans, we’ve put together this refresher on the benefits of QAPI and best practices for ensuring a successful program.

Benefits of an Effective QAPI Program

Why are QAPI programs so important right now? Due to the shift to value-based care, along with referrer incentives for high-quality partners and the narrowing of provider networks based on quality, agencies today are pressed to demonstrate true high performance to payers rather than simply walk through the motions of QAPI as mandated by CMS.

Designing and following a good QAPI program allows agencies to improve quality and performance overall, and results in a wide range of benefits such as:

• A culture of continuous assessment and improvement
• Fewer mistakes
• Improved patient care and outcomes
• Enhanced quality and efficiency of care
• Improved staff satisfaction
• Reduced costs
• Stronger star ratings
• Better reimbursements and referrals

Best Practices for a Successful QAPI Program

Keep your QAPI program simple yet effective

Many agencies fail to implement an effective QAPI program because of its (falsely) perceived difficulty and complexity. Avoid overcomplicating your QAPI program and focus on key components:

• Identify existing gaps and causes in key areas.
• Outline a performance improvement plan to address these gaps.
• Establish a timeline and regular cadence to evaluate the effectiveness of your PI.
• Ensure accurate and proper documentation for all QAPI-related activity.

Focus on people, processes, and technology

Doing so can help you make more effective improvements. For example:

• Ensure that clinicians, staff, patients, and caregivers understand and follow best practices for chronic condition management.
• Look for the types of process updates that have the most impact on avoidable acute care visits and ED utilization.
• Identify the best technologies your agency can deploy to work on improving patients’ physical functioning and condition management.

Quality Analysis Best Practices

Gain a clear understanding of your performance data

Analyze the data from your agency and establish where you are relative to baseline outcomes, especially in key HHVBP assessment areas, such as OASIS, ER visits and hospitalizations, and HHCAHPS.

Identify gaps and shortcomings in these areas along with their respective cause and effect and document these in your QAPI program. Knowing where your agency stands provides a clear roadmap for improvement measures.

Find overlapping root causes

Don’t be in a rush to develop individual performance improvement programs for each gap or shortcoming; instead, find a root cause that affects all key areas. For instance, poor employee engagement or gaps in accurate documentation could simultaneously affect OASIS, ER visits and hospitalizations, and HHCAHPS. Addressing the root cause will make for a more holistic and efficient performance improvement (PI).

Performance Improvement Best Practices

Know the eight key areas that frequently appear on payer scorecards

Develop key strategies for improving scores in each of these areas:

• Timely Initiation of Care
• Improvement in Ambulation
• Improvement in Bed Transferring
• Improvement in Bathing
• Improvement in Shortness of Breath
• Improvement in Management of Oral Medications
• Acute Care Hospitalizations
• Patient Satisfaction

Focus on these three initiatives for better performance

OASIS-based patient outcomes and functional status

Provide a systematic approach to OASIS training that gives new hires the foundation they need to achieve OASIS accuracy and competency while also reinforcing knowledge for seasoned staff.

Hospital and ED utilization

• Learn to better manage complex and chronic conditions with quality education for providers.
• Train leadership on how to properly prepare clinicians for managing complex patients with specialized, leadership-specific courses.
• Help patients better understand their conditions and boost patient activation with targeted, patient-friendly education.
• Improve outcomes with effective home exercise programs and better manage patients in between visits with telehealth and remote monitoring tools.

Patient experience and satisfaction

• Boost patient activation and satisfaction with powerful patient engagement tools.
• Continuously seek out areas for improvement with reporting and analytics capabilities that provide actionable data and remediation options.
• Boost your agency’s HHCAHPS scores with targeted training for clinicians.
• Improve the patient experience with soft skills education for non-clinical but patient-facing staff.
• Elevate the patient experience and improve satisfaction scores with telehealth and remote monitoring solutions.

How MedBridge Can Help

MedBridge offers effective, evidence-based resources designed to help agencies better understand QAPI and implement strategies that improve quality and performance.

The MedBridge Home Health Quality Improvement Solution helps agencies solve for QAPI by addressing key performance gaps and improving quality across multiple areas. Our industry-leading staff training and patient education help boost OASIS accuracy, improve patient satisfaction and HHCAHPS scores, reduce readmissions, and much more.

Learn more with our evidence-based QAPI resources:

Guide: Your QAPI Roadmap: Getting from QA to PI provides best-practice recommendations for tackling the performance improvement piece of QAPI.

Infographic: Quality Improvement in Home Health: How to Create a Feedback Loop for Success explains how performing a continuous, three-step feedback loop can improve outcomes in all areas of focus under HHVBP.

Webinar: Home Health Value-Based Purchasing: Utilizing QAPI Programs to Drive Change provides insights on how developing an effective QAPI program can help your agency achieve and maintain a quality-focused culture that drives excellent outcomes.

Expert-led course: Home Health QAPI provides insight and guidance on how to create or modify a QAPI program by learning about the five standards and their application within an organization.

Solution: Our Home Health Value-Based Purchasing Solution provides everything your agency needs to improve quality and maximize reimbursement under HHVBP.