VBP Submission Report

The VBP Submission Report includes a variety of totals pertaining to Home Health Value-Based Purchasing (HHVBP) data elements that are required by CMS (i.e. Personnel influenza vaccinations, patient herpes zoster/shingles vaccinations, and advance care planning). These totals are displayed by a series of questions that are specific to each data element and data elements are grouped according to the associated Provider Number.

To coincide with the HHVBP functionality, this report provides users with a convenient way to compile required VBP data elements for submitting to CMS via the CMS VBP Portal (for states that are participating in the Value-Based Purchasing payment model). Although agencies cannot submit this to CMS electronically, the report utilizes a user-friendly design to allow for easier data entry. Additionally, this report uses data from the following locations in Enterprise Edition (in addition to the payment source and date of birth).

● Herpes Zoster/Shingles Vaccine section (in Patients | Intake / Referral | Health Screening)

● VBP Type field (in Personnel | Employment)

● Influenza Vaccination section (in Personnel | Licenses)

● Patient Advance Directives information (in Patients | Intake / Referral | Advance Directives)

o Advance Care Plan Discussions sections

o Healthcare Rep/Surrogate Decision Maker field

o Elements Included indicators

● Directive Type/Value Based Purchasing Mapping field (in Reference Files | Advance Directives)

1. Click the arrow beside the Offices field and then select the checkbox(es) beside the office(s) you want to use for the report. To include all offices, click the top-level checkbox.

2. When the Show Details box is checked, all individual patients and personnel (that contain applicable VBP data) will be included in the report. This box is checked by default.

3. If desired, users are able to select a custom date range using the Date From and Date Thru fields. By default, the software defaults to the current CMS quarterly timeframe.

The VBP Submission Report includes the following specifications::

● Header information:

o Office Number

o Date Range

The basic version of the report (if the Show Details box is unchecked) includes the following sections and sub-sections, which contain any applicable totals that display to the left of each individual question/statement:

● Staff Influenza Vaccination – Employee for Provider Number: [--- Applicable Provider Number ---]

o General Questions:

§ The number of home health care employees who were working in the home health agency for at least 1 working day between October 1 and March 31. (Employees: All person who receive a direct paycheck from the reporting HHA, that is on the agency’s payroll.)

§ How many of the HHA employees were offered the influenza vaccine?

§ How many of the HHA employees received the influenza vaccine from the HHA?

§ How many of the HHA employees provided documentation for receiving the influenza vaccine from a setting outside of the HHA? Examples may include a primary care office, clinic, hospital, or pharmacy.

o Contraindications:

§ How many of the HHA employees declined influenza vaccine due to an allergy?

§ How many of the HHA employees declined influenza vaccine due to a compromised immune system?

§ How many of the HHA employees declined influenza vaccine due to a previous adverse reaction?

§ How many of the HHA employees declined influenza vaccine due to additional medical illnesses or contraindications?

o Reasons for declining the influenza vaccine:

§ How many of the HHA employees declined influenza vaccine due to spiritual or religious beliefs?

§ How many of the HHA employees declined influenza vaccine without providing a reason?

§ How many of the HHA employees declined influenza vaccine due to additional reasons?

§ Additional reasons for employees declining influenza vaccine:

[ ---Textbox below will indicate any applicable ‘additional reasons’ that were specified --- ]

● Herpes Zoster Vaccinations (Shingles Vaccine) for Patients for Provider Number: [--- Applicable Provider Number ---]

o General Questions:

§ How many Medicare beneficiaries aged 60 years or older received services from the HHA during the reporting period? (Calculated as the number of Medicare beneficiaries aged 60 years or older discharged from the HHA, transferred to an inpatient facility, or died during the reporting period.)

§ At home health start of care, how many Medicare beneficiaries aged 60 years and older report ever receiving the shingles vaccine?

o Of those Medicare beneficiaries aged 60 years and older who at home health start of care report to have never received the shingles vaccine:

§ How many were then offered the vaccine by the HHA prior to home health discharge, transfer to an inpatient facility, or death during the reporting period?

§ How many received the vaccine from the HHA prior to home health discharge, transfer to an inpatient facility, or death during the reporting period?

§ How many received the vaccine from another provider (physician, pharmacy, etc.) prior to home health discharge, transfer to an inpatient facility, or death during the reporting period?

o Contraindications:

§ How many patients declined the shingles vaccine due to an allergy?

§ How many patients declined the shingles vaccine due to a compromised immune system? Examples may include cancer treatment or a disease affecting the immune system like HIV/AIDS?

§ How many patients declined the shingles vaccine due to additional medical illnesses or contraindications?

o Reasons for declining the shingles vaccine:

§ How many patients declined the shingles vaccine due to spiritual or religious beliefs?

§ How many patients declined the shingles vaccine due to financial reasons?

§ How many patients declined the shingles vaccine due to lack of access to the shingles vaccine?

§ How many patients declined the shingles vaccine due without providing a reason?

§ How many patients declined the shingles vaccine due to additional reasons?

§ Additional reasons for patients declining influenza vaccine:

[ ---Textbox below will indicate any applicable ‘additional reasons’ that were specified --- ]

● Advance Care Plan for Provider Number: [--- Applicable Provider Number ---]

o General Questions:

§ How many patients 65 years or older received services from the agency during the reporting period? (Calculated as the number of patients 65 years or older discharged from the HHA, transferred to an inpatient facility, or died during the reporting period.)

§ How many patients who are Medicare Beneficiaries, including dually-eligible beneficiaries, received services from the HHA during the reporting period?

o At the start of care, how many patients aged 65 and older:

§ Had an advance care plan documented in the home health medical record?

§ Had a surrogate decision maker documented in the home health medical record?

o At discharge, transfer to an inpatient facility or death, how many patients aged 65 and older:

§ Had an advance care plan documented in the home health medical record?

§ Had a surrogate decision maker documented in the home health medical record?

§ Had a discussion with the HHA staff but did not wish to provide an advance care plan or name a surrogate?

§ Had a discussion with the HHA staff but were not able to provide an advance care plan or name a surrogate?

§ Did not have any discussion with HHA staff related to an advance care plan or surrogate decision maker?

o How many patients with an advance care plan had the following information documented in the advance care plan:

§ Medical treatment preferences

§ Mental health/behavioral treatment preferences

§ Cultural/social preferences

§ Spiritual/religious preferences

The expanded version of the report (if "Show Details" box is checked) includes additional details that utilize data for all applicable patients and personnel (i.e. Employees, independent licensed practitioners, adult student trainee/volunteers). Detailed below is each additional page of the report that is included, as well as the associated columns of data for each:

● Staff Influenza Vaccination - Employees

o Employee Name

o Provider Number

o General Questions

§ Total Worked

§ Vac Offered

§ Vac Rcvd

§ Declined Outside HHA

o Contraindications

§ Declined Allergy

§ Declined Immune System

§ Declined Adverse Reaction

§ Declined Other Reason

o Reasons for Declining

§ Declined Spiritual

§ Declined No Reason

§ Declined Additional Reason

o Declined Additional Reason Text

● Herpes Zoster Vaccination (Shingles Vaccine) for Patients

o Patient Name

o Provider Number

o General Questions

§ Received Services

§ Before SOC

o No shingles vaccination prior to SOC

§ Vac Offered

§ Vac Received

§ Declined Outside HHA

o Contraindications

§ Declined Allergy

§ Declined Immune System

§ Declined Other Reason

o Reasons for declining shingles vaccine:

§ Declined Spiritual

§ Declined Financial

§ Declined Lack of Access

§ Declined No Reason

§ Declined Additional Reason

o Declined Additional Reason Text

● Advance Care Plan for Patients

o Patient Name

o Provider Number

o General Questions

§ Over 65 rcvd srvcs

§ Medicare patients rec svcs

o At SOC, did patients have:

§ Advance Care Plan

§ Surrogate decision maker

o At discharge, transfer, or death, did patients have:

§ Advance Care Plan

§ Surrogate decision maker

§ Did not wish to answer

§ Were not able to answer

§ No discussion occurred

o Did patients with adv care plan have preferences:

§ Medical treatment

§ Mental health / behavioral

§ Cultural / social

§ Spiritual / religious

o Declined Additional Reason Text