Medicare Compliance & Reimbursement

Get to know these crucial consensus measures.

 It's only a matter of time before Medicare implements a pay-for-perform Get to know these crucial consensus measures It's only a matter of time before Medicare implements a pay-for-performance (P4P) system for home health agencies, experts agree.
 
Here are nine measures you're likely to be judged -- and paid -- on in P4P's early days, since the Agency for Healthcare Research and Quality (AHRQ), the National Quality Forum (NQF) and the Centers for Medicare & Medicaid Services (CMS) agree on them, according to the Medicare Payment Advisory Commission's (MedPAC) June report to Congress:

 1. Improvement in shortness of breath.
 2. Improvement in bladder control.
 3. Improvement in bathing.
 4. Improvement in oral-medication management.
 5. Improvement in walking or moving around.
 6. Improvement in getting in or out of bed.
 7. Improvement in pain interfering with activity.
 8. Any emergency care provided.
 9. Acute care hospitalization.
 
Front-runner: Medication management is especially likely to play an important role in P4P, predicts consultant Ronald Clitherow with LarsonAllen based in Charlotte, NC. Medicare has "huge cost issues ... regarding rehospitalization due to patient failures to remain medication compliant," Clitherow notes.
 
That means emergency care related to medications, another measure currently endorsed by NQF but not AHRQ or CMS, could show up on P4P's measure list as well.
 
Note: The MedPAC report chapter on home health is at www.medpac.gov/publications/congressional_reports/Jun06_Ch05.pdf.ance (P4P) system for home health agencies, experts agree.
 Here are nine measures you're likely to be judged ...quot; and paid ...quot; on in P4P's early days, since the Agency for Healthcare Research and Quality (AHRQ), the National Quality Forum (NQF) and the Centers for Medicare & Medicaid Services (CMS) agree on them, according to the Medicare Payment Advisory Commission's (MedPAC) June report to Congress:
 1. Improvement in shortness of breath.
 2. Improvement in bladder control.
 3. Improvement in bathing.
 4. Improvement in management of oral medications.
 5. Improvement in walking or moving around.
 6. Improvement in getting in or out of bed.
 7. Improvement in pain interfering with activity.
 8. Any emergency care provided.
 9. Acute care hospitalization.
 
 Front-runner: Medication management is especially likely to play an important role in P4P, predicts consultant Ronald Clitherow with LarsonAllen based in Charlotte, NC. Medicare has "huge cost issues ... regarding rehospitalization due to patient failures to remain medication compliant," Clitherow notes.
 That means emergency care related to medications, another measure currently endorsed by NQF but not AHRQ or CMS, could show up on P4P's measure list as well.
 Note: The MedPAC report chapter on home health is at www.medpac.gov/publications/congressional_reports/ Jun06_Ch05.pdf.