(PHOTO: Lisa Steiner and Executive Director Jill Over)

The Clarion Forest VNA home health care services earned four stars for quality of care and five stars in patient surveys out of five stars. Clarion Forest VNA Hospice was also designated as a premier performer.

The stars are a measure of quality and also help determine reimbursement.

“We’ve had a really good year,” said VNA Executive Director Jill Over. “Lisa Steiner is now our chief nursing officer over home health care and palliative care. She’s basically running the whole clinical show.  Throughout the year, both our hospice and home health have accomplishments and received accolades from the powers that be.”

Steiner, a nurse for 31 years and an employee at VNA for 25 years, replaced Beth Cook who retired.

“We’re a four-star Home Health agency in quality of care and five stars in patient surveys,” said Steiner. “The Center for Medicare and Medicaid Service (CMS) established the Skilled Nursing Facility Quality Reporting Program (SNF) and Highmark presents a scorecard quarterly and we are ranked seventh out of 138 Home Health Agencies in Pennsylvania.”

“There are more home health agencies than that, but Highmark has started eliminating home health agencies who don’t meet their standards,” said Over. “There used to be about 160, but it’s down to 138 and our score was seven.”

CFVNA Hospice was just awarded premier performer status by Strategic Health Planning (SHP) with an overall score that ranked it in the top five percent of the Consumer Assessment of Healthcare Providers (CAHPS) quality measure for the 2018 calendar year.

“SHP is a company we contract with,” Over said. “They don’t have every agency in Clarion County as a customer, but they are the premier vendor that sends out surveys and have the best agencies in the country using their service for patient surveys and does analytics.

“If you’re in the top five percent, that means you’re pretty dang good.”

The stars are important for any health care service today because the quality measure also affects your reimbursements from Medicare and Medicaid. The stars also relate to a variety of factors that are all considered.

“It relates to timeliness initiation of care and 30-day hospital readmissions,” said Steiner. “Everybody—-CMS and insurance providers–are really looking at re-admission rates. They use the CMS star quality as well in their scorecard data, they look at 30-day emergency rooms, and they really are looking now at  Primary Care Physician (PCP) follow-ups in seven days through patient claims to see if the patient followed up with their PCP because they feel that helps reduce rehospitalizations.”

Word on the street, according to Over, is that CFVNA also is getting a scorecard from UPMC.

Hospice Item Set (HIS) is an attempt to monitor hospice like home health care and is an assessment based on the data generated for the state by CFVNA. The data shows the outcomes.

“At this point, hospice doesn’t have a star rating like home healthcare,” Over said. “They will eventually, but they don’t have it yet. HIS is sort of the substitute.”

“We always score really well,” said Steiner. “CMS is really data driven, and they want to look at outcomes because in the next several years — it’s not going away — CMS will require agencies, hospitals, SNF’s and get paid based on their value of care for value-driven care. That’s why we have all of these scorecards, and we have to focus on continuing to do well. If you don’t, you will get hit with your reimbursement when you score low.”