CMS Unveils Medicare Quality Improvement Initiatives
By - The Centers for Medicare and Medicaid Services (CMS) announced two new Medicare quality improvement initiatives yesterday. The agency said that it will expand and strengthen its Five Star Quality Rating System, which is used in nursing homes. The move is expected to improve consumer information about individual nursing homes’ quality.
For the Nursing Home Five Star Quality Rating System, CMS plans to improve survey inspections, payroll-based staffing reporting, additional quality measures, timely and complete inspection data, and the scoring methodology.
Specifically, starting in January 2015, CMS and states will implement more focused survey inspections to enable better verification of both the staffing and quality measure information. CMS will also implement a quarterly electronic reporting system that is auditable back to payrolls to verify staffing information.
Moreover, CMS explained that it will strengthen requirements to ensure states maintain a user-friendly website, while also completing inspections of nursing homes in a timely and accurate manner. The scoring methodology itself will also be improved, and CMS will increase the number and type of quality measures used overall.
“Nursing homes are working to improve their quality, and we are improving how we measure that quality,” Patrick Conway, M.D., deputy administrator for innovation and quality and CMS chief medical officer, said in a statement. “We believe the improvements we are making to the Five Star system will add confidence that the reported improvements are genuine, are sustained, and are benefiting residents.”
Additionally, CMS proposed conditions of participation for home health agencies. This will modernize Medicare’s Home Health Agency Conditions of Participation, ensuring safe delivery of quality care to home health patients, CMS said.
For example, the agency wants to strengthen patient rights and improve the communication that focuses on patient wellbeing. This will be the first time since 1989 that home health regulations will be modernized, with a focus on patient-centered, well-coordinated care.
Specifically, CMS explained that the new regulations will include the expansion of patient rights requirements and will also refocus the patient assessment on physical, mental, emotional, and psychosocial conditions. Additionally, CMS wants to improve the communication systems and requirements for a data-driven quality assessment, along with improving the performance improvement (QAPI) program.
According to CMS Administrator Marilyn Tavenner, CMS is “focused on using as many tools as are available to promote quality improvement and better outcomes for Medicare beneficiaries.” Moreover, Tavenner said the agency’s overall goal is to improve patient outcomes.
Home health seems to be an issue that CMS wants to improve. Earlier this year, the agency announced a proposed rule for the home health prospective payment system (HH PPS) refinements. Additionally, the rule is expected to create a net reduction in burden of $21.55 million associated with certifying patient eligibility for home health services & certification form revisions.
