OASIS Alert

Published on Tue Aug 19, 2008 PDF

9th Scope of Work will include home health.

Home health agencies worried that they might miss out on the Quality Improvement Organizations' upcoming 9th Scope of Work (SOW) can breathe a sigh of relief.

Many HHAs felt abandoned when the Centers for Medicare & Medicaid Services earlier indicated that QIOs would dramatically scale back their HHA assistance in the next cycle of their contract. But now CMS says it will launch a new Home Health Quality Campaign under the 9th Scope of Work, according to the National Association for Home Care & Hospice.

Background: CMS announced on Aug. 12 that it had awarded contracts for the 9th SOW for the 54 contractors participating in Medicare's Quality Improvement Organization (QIO) program.

The QIOs will target three main themes: beneficiary protection, patient safety, and prevention. Though originally not mentioned, each facet of the SOW will contain a homehealth slant. For instance, QIOs will approach home health improvement through beneficiary complaints and service termination appeals, CMS stated.

During the 8th SOW, the QIOs focused intensely on helping HHAs reduce unplanned hospitalizations. While the rate did not go down as a national average, many states and agencies reported progress. The 4,352 agencies that registered when the campaign began in early 2007 reduced hospitalizations by 5 percent than non-participating agencies, Quality Insights of Pennsylvania reported.

Next step: CMS indicated that the new campaign may focus on broader improvement measures, as well as on collaboration between hospitals and physicians' offices.

However, agencies will have to wait to find out whether the Home Health Quality Initiative under the 9th SOW will pick up where the earlier one left off. "The exact nature and extent of new campaign activities under the next SOW was not revealed since QIOs will engage in a competitive bidding process for the home health contract," NAHC said in its August newsletter for members.

More than anything else, agencies "need access to resources that will improve their practices," says Mary St. Pierre, MGA, BSN, RN, VP of regulatory affairs for NAHC. For example, under the 8th SOW, practices
didn't have to invest their time and money into developing training materials and tools. "It would be terrific if the HHQC continues along the same line," she notes.

Many of the 8th SOW's support structures are likely to continue. For instance, home health agencies that participated in the Quality Campaign will be able to access expedited quality reports on CASPER later this year and the HHQI National Campaign and Setting Targets-Achieving Results Web sites will remain updated sources of information, NAHC told its members.

"Phase two of the Home Health Quality Initiative is really still in action," explained CMS staffer Debbie Terkay in a recent Open Door Forum. CMS plans to ask for Home Health Quality Campaign proposals from QIOs in October and expects to award a lead contract sometime in January of 2010, she said.

Resources: In the meantime, brush up on the 9th SOW at http://www.cms.hhs.gov/QualityImprovementOrgs/downloads/9thSOAnnouncement080508.pdf, www.cms.hhs.gov/QualityImprovementOrgs, and www.qualitynet.org/MedQIC.