POQA
Quality Assurance for Phase II of the Home Health Agency Prospective Payment
Demonstration
(Home Health PPS QA/I Demonstration)
Funded by: Health Care Financing Administration
Project Period: 1995 - 2001
The major objectives of this project were: (1) to monitor quality of care under
Medicare's home health agency per-episode prospective payment demonstration and
intervene to correct any major quality of care problems detected and (2) to
provide data for comparing quality of care between agencies receiving
prospective payment (treatment agencies) and agencies receiving standard
cost-based reimbursement (control agencies), using a modified version of the
outcome-based quality improvement (OBQI) system that Medicare has implemented
nationwide. All 91 home health agencies that participated in the prospective
payment demonstration, both treatment and control agencies, provided data,
received annual outcome reports, and conducted process-of-care reviews. The
evaluation activities conducted by the Research Center for this project included
assessing the quality performance (measured by patient outcomes) of treatment
relative to control agencies to assess whether prospective payment (under the
payment methodology used in the demonstration) resulted in provider actions
that reduced quality of care and patient outcomes. (Generally, no significant
reduction in outcomes were found.) The analyses involved patient-level case
mix and outcome data as well as Medicare claims data on Medicare service use,
particularly inpatient hospitalization.
Key Staff: Hittle, Bennett, Schlenker
Research Monographs:
Bennett RE, Hittle DF, Schlenker RE. Pitfalls, Problems, and Lessons Learned Implementing Outcome-Based Quality Improvement (OBQI) for PPS Demonstration Agencies, November 1998.
Engle K, Hittle DF, Bennett RE, Schlenker RE. April 1999 Annual Report, Second Year Outcome Findings, April 1999.
Engle K, Hittle DF, Schlenker RE. May 2000 Annual Report, First and Second Year Combined Outcome Findings, May 2000.
Schlenker RE, Grigsby J, Powell MC, Goodrich GK. Normative Standards for Medicare Home Health Utilization: Final Report for the Prospective Payment Project Component, July 2001.
Hittle DF, Engle KE, Bennett RE, Baillie LL, Crisler KS, Schlenker RE. Final Report: Quality Assurance Activities and Findings, July 2001.
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