Key Points to Know About the New COVID-19 Quality Measure

What you need to know about this process quality measure

The CY 2024 Home Health Prospective Payment System (HH PPS) final rule [CMS-1780-F] finalized the adoption of the measure “COVID-19 Vaccine: Percent of Patients/Residents Who are Up to Date” (Patient/Resident COVID-19 Vaccine) to the Home Health Quality Reporting Program (HH QRP) beginning with the CY 2025 HH QRP.

The Patient/Resident COVID-19 Vaccine measure reports the percentage of home health quality episodes in which patients were up to date with their COVID-19 vaccinations as defined by Centers for Disease Control and Prevention (CDC) guidelines on current vaccination.

This measure is an assessment-based, post-acute care (PAC) cross-setting process measure which has no exclusions and is not risk adjusted. The measure’s numerator will be the total number of home health patients that are up to date with the COVID–19 vaccine during the reporting period.

The measure’s denominator will be the total number of home health quality episodes with an end of care OASIS (Discharge, Transfer or Death at Home) during the reporting period. The data source for the final home health Patient/ Resident COVID–19 Vaccine measure is the OASIS assessment instrument.

Why CMS adopted this measure for HH QRP and how to plan for success

The purpose of the Patient/Resident COVID-19 Vaccine measure is to report the rate of patient/resident-level vaccination in PAC facilities and home health agencies. Studies have shown that being up to date on COVID-19 vaccines provides strong protection against severe disease, hospitalization, and death in adults.2

Given the demonstrated positive impact of COVID-19 vaccination, PAC providers, including home health, are in a unique position to leverage their care processes to address vaccination coverage in these settings. The COVID-19 Vaccine quality measure continues CMS’s commitment to promoting the uptake of the COVID-19 vaccine and ensures alignment with current CDC guidance.

Since the patient’s COVID– 19 vaccination status will be reported at end of care from the HHA, if a patient is not up to date with their COVID–19 vaccination per applicable CDC guidance at the time they are admitted, the HHA has the opportunity to educate the patient and provide information on why they should become up to date with their COVID–19 vaccination.

HHAs may also choose to administer the vaccine to the patient prior to their discharge from the HHA or coordinate a follow up visit for the patient to obtain the vaccine at their physician’s office or local pharmacy.

What home health providers should expect and how to find more information

CMS has shared that data collection is anticipated to begin for patients discharged on and after January 1, 2025, and that we can expect HHA performance on this measure to be included on Care Compare in January 2026. A new item will be added to the current OASIS item set to collect information on whether a patient is up to date with their COVID–19 vaccine at the time of discharge from the HHA.

A draft of the new item is available in the technical specifications document COVID–19 Vaccine: Percent of Patients/Residents Who Are Up to Date Draft Measure Specifications, and provided below:

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Stay up to date on new CMS information related to HHVBP and OASIS accuracy.

 

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