HHRG


Also found in: Acronyms.

HHRG

Home health resource group Medicare A case-mix classification in which Pt characteristics and health status information are obtained from an OASIS assessment in conjunction with projected therapy use during a 60-day episode are used to determine Medicare reimbursement.
Mentioned in ?
References in periodicals archive ?
For the PPS episodes, we used the HHRG classification determined by CMS, adjusting the service classification, if necessary, based on actual therapy visits from the claims data.
Because the HHRGs were developed to take into account differences in patient case mix that affect the utilization of services, the case-mix variables in our visit regressions were dichotomies to represent the levels of each HHRG dimension.
Some OASIS items are used both to determine the HHRG for payment and as risk factors in the CMS outcome models.
We used the outcome episode as the unit of analysis and removed outcome episodes longer than 60 days and episodes beginning with a resumption of care rather than a SOC assessment--longer episodes because the HHRG can change for the subsequent payment period, and resumptions of care because the HHRG calculated from resumption of care OASIS information may not be the HHRG derived at SOC on which payment is based.
Table 2 shows the pre-PPS and PPS changes in the HHRG distribution and visits per episode.
With adjustment for the shift in the HHRG distribution, total visits per episode were 16.
Since the wound item affects the HHRG classification and payment amount, the importance of accurate reporting on wounds increased substantially after PPS implementation.
dagger]) Identical OASIS item used for HHRG determination (nine items in this model).
Using estimates of revenue based on case-mix frequency and national basic reimbursement rates from the Health Care Financing Administration, a probability sample of HHRGs was selected to replace our previous sample of Medicare items.
Malcolm added, "We did a lot of testing by putting in OASIS data to make sure it calculated the HHRGs and cross checked it manually based on the MSA wage index to compare payment information.