With QAPIs, Home Health Providers Should Opt For Tailored Approaches

Curating a specific plan based on a home health provider’s needs, deficiencies and vulnerabilities is key to having successful Quality Assurance and Performance Improvement (QAPI) programs.

That was the message from Tammy Stewart, clinical consultant with Healthcare Provider Solutions Inc., during a presentation on building a successful QAPI after the nationwide expansion of the Home Health Value-Based Purchasing (HHVBP) Model.

“All you providers, you have to ensure that your QAPI program is designed to help you,” Stewart said. “Choose activities to monitor based on your deficiencies. Action plan. Focus on high-risk, high-volume and problem-prone areas and have an immediate correction of any problems that might threaten the health and safety of patients.”


Broadly, QAPI refers to any kind of auditing or quality metric standards a home health agency hopes to abide by.

Quality assurance usually refers to documentation review. The performance improvement aspect, or second part, refers to the actions taken by providers.

QAPI became standardized in home health care when updates were made to the conditions of participation in 2018.


The goal of QAPI is to ensure a high quality of care while identifying opportunities for improvement and addressing gaps in systems or processes.

Although it may seem that home health providers should follow a by-the-book process, Stewart said it’s important to be as specific as possible when creating a QAPI program.

“Providers should develop a QAPI plan that reflects the complexity of your organization, and all services provided, that includes the data that will be collected and the frequency in which the data will be collected,” Stewart said.

These reports and programs should not be an administrative-level process, either.

“Providers need to educate the entire staff on the QAPI process and train them to help with clinical record reviews,” Stewart said. “The quickest, simplest way to see improvement is to share this information and these reports with your staff. Involving your entire staff will lead to improved performance.”

The frequency of QAPI reports is also an important factor in getting better results. Stewart said the frequency of the reports are dependent on what kind of data is involved.

“The program must show the agency actions taken to address performance, including the prevention and reduction of medical errors,” Stewart said. “You’ll need to determine who will review the data and how often the data will be reviewed. Some areas will warrant continuous evaluation, while others may warrant only once a quarter or annual evaluation.”

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