CMS Seeking Feedback on Quality, Efficiency Measures in Home Health National Provider Survey

At times, home health stakeholders have knocked the U.S. Centers for Medicare & Medicaid Services (CMS) for not listening to industry concerns, particularly when it comes to the introduction of new payment models.

CMS is now looking to buck that trend — at least in one specific regard.

On Thursday, the agency posted a notice in the Federal Register, the U.S. government’s daily journal, letting the public know that it is seeking approval on a survey and “qualitative interview guide” for the home health setting. Information potentially collected through the efforts would be used to address critical needs regarding the impact of use of quality and efficiency measures, including the burden they impose on home health agencies, according to CMS.


The collection efforts are part of the agency’s Home Health National Provider Survey and required by law as a result of a provision in the Social Security Act.

Specifically, the Social Security Act requires the U.S. Department of Health and Human Services to assess the quality and efficiency effects of the use of endorsed measures in specific Medicare quality reporting and incentive programs every three years.

Findings from surveys and qualitative interviews would be used for multiple purposes, CMS stated in the Federal Register notice.


The qualitative interviews and a standardized survey will inform the agency about the impact of measures used to assess care in home health agencies.

Additionally, the surveys will help federal policymakers understand whether the use of performance measures has been associated with changes in home health agencies behavior, according to CMS. Namely, CMS wants to gather more information on what quality improvements investments home health agencies are making — and whether adoption of those quality improvements changes is associated with higher performance on measures.

Furthermore, the survey will help policymakers identify characteristics associated with high agency performance, CMS stated in its notice. That performance information could then, in theory, be used to leverage improvements in care among lower-performing agencies.

Washington, D.C.-based National Association for Home Care & Hospice (NAHC), a nonprofit organization that represents the nation’s 33,000 home care and hospice organizations, is among the organizations in support of CMS’ plans to craft more meaningful measures.

“NAHC supports CMS’ meaningful measures initiative and looks forward to working with CMS in bringing forth a quality measure set that encourages quality and efficiency in home health care,” Mary Carr, NAHC vice president for regulatory affairs, told Home Health Care News.

The home health industry has until Jan. 14, 2019 to comment on CMS information collection initiative.

If approved, CMS estimates that there would be 1,040 respondents included in the effort with responses taking approximately one hour.

The survey and interviews, assuming approval by August 2019, would be fielded from fall 2019 through spring 2020.

Written by Robert Holly

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