WASHINGTON, D.C. (November 26, 2019)—The National Quality Forum (NQF) recently posted the list of Measures Under Consideration (MUC) for future use in the hospice quality reporting program (HQRP) and the home health quality reporting program (HHQRP). The list is released annually, and there is an opportunity for stakeholder comment. In fact, comments were due Nov. 25, 2019.
The Measures Under Consideration (MUC) are also reviewed by the Measure Applications Partnership (MAP), which is a statutorily required multi-stakeholder group. The MAP is convened by the National Quality Forum (NQF) and will review the measures and make recommendations to the Centers for Medicare & Medicaid (CMS) regarding the use of the proposed measures in the various quality reporting programs. The results of the review are typically available in the first quarter of the calendar year. Inclusion of a measure on this list does not require CMS to adopt the measure for the identified program.
There is one measure on the list for the HQRP and one measure for the HHQRP. Please see a summary of these measures below.
Hospice Measures Under Consideration
Hospice Visits in the Last Days of Life
The proportion of hospice patients who have received visits from a Registered Nurse or Medical Social Worker (non-telephonically) on at least two out of the final three days of the patient’s life
Home Health Measures Under Consideration
Home Health Within-Stay Potentially Preventable Hospitalization Measure
This measure reports a home health agency (HHA)- level rate of risk-adjusted potentially preventable hospitalizations or observation stays that occur within a home health (HH) stay for all eligible stays at each agency. A HH stay is a sequence of HH payment episodes separated from other HH payment episodes by at least two days
The Hospice Visits in the Last Days of Life measure that is under consideration is a variation of the existing HQRP measure by the same name. Currently, this is a paired measure that assesses hospice staff visits to patients at the end of life over three or seven days.
The first measure assesses the percentage of patients who receive at least one visit from a registered nurse, physician, nurse practitioner, or physician assistant in the last three days of life.
The second measure (Measure 2) assesses the percentage of patients receiving at least two visits from a medical social worker, chaplain or spiritual counselor, licensed practical nurse, or hospice aide in the last seven days of life.
Last year, CMS announced that it was going to publicly report the first measure of this paired measure, visits in the last three days of life, on Hospice Compare. The posting of this information began in 2019. However, CMS indicated that it was not going to publicly report the second measure, visits in the last seven days of life, because this measure did not meet reporting criteria. Instead, CMS was going to continue testing of this measure.
The home health measure under consideration addresses another angle of potentially preventable incidents and hospitalizations. These topics are also addressed with some of the existing HHQRP measures.