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Strengthening QAPI for HHVBP

    Along with the outset of Home Health Value-Based Purchasing (HHVBP) in 2023 is the heightened importance of the Quality Assurance Performance Improvement (QAPI) program. QAPI program plays an integral role in HHVBP, which is why it is important for home health agencies to improve and leverage their QAPI program to avoid being at the losing end in the new HHVBP landscape.

    Factors to Focus On

    To take advantage of the HHVBP program’s benefits, agencies should actively work on the Performance Improvement (PI) aspect. This includes both patient satisfaction and clinical competence relative to the OASIS, which directly impact VBP results. Subsequently, targeted OASIS training on each item identified in the program is crucial. In addition, Certification And Survey Provider Enhanced Reports (CASPER) and scrubbers used in the organization can determine areas for improvement in OASIS data collection.

    Tips to Improve Your QAPI Program

    Here are a few practical tips on how to improve your QAPI program:

    1. Review CASPER reports and individual scrubber items to identify challenges and address them.
    2. Review data from your OASIS QA review program to pin down areas for improvement in patient case-specific OASIS documentation.
    3. Focus on these OASIS items in trainings and evaluations for current and new employees:
    • M 1800-Grooming
    • M 1810-Dress Upper Body
    • M 1820-Dress Lower Body
    • M1830-Bathing
    • M1840 Toilet Transfer
    • M1845-Toilet Hygiene
    • M1850-Transfer
    • M1860-Ambulation/locomotion
    • M1870-Feeding/Eating
    1. Use the QAPI program to assist in evaluating patient and caregiver experience of home health services. Assess their understanding of how the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey will work post-discharge. This training should be included in each discharge visit.

    Make QAPI Work for You

    To thrive in the HHVBP landscape, leverage your QA functions to drive PI initiatives. For instance, your OASIS review team or provider should be able to provide practical insights about your clinicians’ competency in patient assessment documentation in the OASIS. Evaluating the quality of care your agency provides as early as now will create a domino effect in achieving positive patient outcomes and ultimately, business growth. 

    The Plan, Do, Study, Act (PDSA) Methodology

    Agencies can simplify QAPI by utilizing an effective process improvement framework to test implemented changes.  After an accurate assessment of baseline key performance areas, many risk areas and deficiencies are often revealed.  Once a priority area is determined, the journey to improvement begins.

    In order to build and execute your process improvements, one effective method that can be leveraged is the Plan-Do-Study-Act (PDSA) cycle. Going through the prescribed four steps guides the thinking process into breaking down a task into steps and then evaluating the outcome, improving on it, and testing again. PDSA is a recommended approach that gives surveyors a comprehensive view of an agency’s QAPI initiatives. Incorporate PDSA cycles in your QAPI using our free PDSA worksheet.