CMS Releases First Round of Home Health Compare Ratings

Members | May 07, 2015

The Home Health Quality of Patient Care Star Ratings Preview Reports are now available in the CASPER folders. A Centers for Medicare and Medicaid Services (CMS) spokesperson said, “This preview report will provide agencies the opportunity to see how they compare on star ratings."

The Centers for Medicare and Medicaid Services (CMS) has published star ratings on Home Health Compare, and the Quality of Patient Care Star Ratings Preview Reports are now available in the CASPER folders. 

The preview reports will include data from patients served from April 2014 through March 2015, but agency star ratings will not be publicly reported.  

These reports contain data that will be publicly reported on Home Health Compare in January 2016. 

“This preview report will provide agencies the opportunity to see how they compare on star ratings," a CMS spokesperson said. 

The deadline to submit a request to have the star rating data suppressed is October 17, 2015. 

Please follow the directions laid out in the Preview Reports to submit a suppression request.  

Home Health Compare Refresh

The refresh of the Home Health Compare website will occur on October 8th. The data presented on HHC in October were previewed in the reports posted on CASPER in July. 

Some providers may see small differences between the measure value displayed on Home Health Compare in October and that shown on their preview reports sent out in July, for select measures.  

This is because measure values were recalculated after the dissemination of the preview reports to include any late or corrected submission received after measure values were initially calculated, for each month during the 12-month reporting period. 

This recalculation did not affect the Quality of Patient Care star rating, or any of the measures included in its calculation. 

Going forward, the data tables used to calculate measures for Home Health Compare will be updated prior to the dissemination of the preview reports to capture any late or corrected OASIS submissions, and then frozen until display on Home Health Compare.  

Home Health Compare will continue to be updated on a quarterly basis.

According to CMS, the star ratings for Medicare Certified Home Health will help consumers obtain information about a home health agency's performance, and will help the home health agencies by providing data to help identify areas for improvement.

Each home health agency receives a single summary Quality of Patient Care Star Rating encompassing that agency’s relative performance on 9 of the 29 quality measures already posted on Home Health Compare, including:

  • How often the home health team began their patients’ care in a timely manner.

  • How often the home health team made sure that their patients have received a flu shot for the current flu season.

  • How often the home health team taught patients (or their family caregivers) about their prescribed drugs.

  • How often home health patients got better at walking or moving around.

  • How often home health patients got better at getting in and out of bed.

  • How often home health patients had less pain when moving around.

  • How often home health patients got better at bathing.

  • How often home health patients’ breathing improved.

  • How often home health patients had to be admitted to the hospital.

The measures are calculated using information from patient assessments and from Medicare claims. When calculating patient outcomes, statistical models are used to adjust for differences in the types of patients served by different agencies.

More than 9,300 agencies nationwide received a rating, and 46% received 3 or 3.5 stars. Only 6 agencies received a single star in this first release, while 239 agencies received 5 stars.

States where 1/3 or more of rated HHAs scored 4 or more stars:

  • Alabama
  • California
  • Florida
  • Maryland
  • New Jersey
  • Pennsylvania
  • Rhode Island
  • South Dakota
  • Utah

States where 4 out of 10 agencies or more received less than 3 stars:

  • Alaska
  • Arkansas
  • Minnesota
  • Ohio
  • Oregon
  • Texas
  • Wyoming
  • District of Columbia 

The new Home Health Compare Quality of Patient Care Star Ratings will be updated each quarter as more recent data become available. 

Also, CMS plans to introduce additional star ratings based on a patient experience of care survey (the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) instrument) in January 2016. 

History of the Home Health Star Ratings 

The Centers for Medicare and Medicaid Services (CMS) held an Open Door Forum call on May 7 about the new “Home Health Patient Survey Star Rating" that begins in January of 2016. 

The “Patient Survey Star Rating" begins on January 2016, and will be based on data from the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey. 

The first publicly reported star ratings, to be released in January of next year, will reflect data from patients served from July 2014 through June 2015.

The HHCAHPS Survey is a national, standardized, 34-item survey of patients’ experience of care received from their home health agency. The surveys are conducted by independent survey vendors and can be completed via mail, phone or through a mix of both.

There will also be a “Quality of Patient Care Star Rating” that will be based on OASIS assessments and claims data. 

The new OASIS-based star ratings are set to be posted for the public in July.

4 HHCAHPS Measures Will Be Rated

The following 4 HHCAHPS measures will receive a star rating:

  1. Care of patients.
  2. Communication between providers and patients.
  3. Specific care issues.
  4. Overall rating of care provided by the home health agency.

There will also be a Survey Summary Star Rating.

Home health agencies that have at least 40 completed surveys over the four-quarter reporting period will be eligible for HHCAHPS star ratings. Home health agencies that do not have sufficient completed surveys will have their HHCAHPS measures reported on Home Health Compare.

A CMS spokesperson on the Open Door Forum call said individual survey responses are converted into linear scores on a scale of 0 to 100 points. 

The score will reflect both positive and negative responses, although more positive responses will receive a higher value. 

CMS will create a “patient mix,” which adjusts for patient characteristics that affect response One of the patient mix factors is whether that client lives alone. 

The agency spokesperson said, “Patients who live alone tend to give lower scores, which is clearly outside of agencies’ control.” 

Other patient mix adjusters include age, education, and language in which survey was completed. 

After patient mix adjusters are applied, linearized scores are then converted into HHCAHPS star ratings in a process that involves a statistical clustering technique, which is meant to “maximize differences between groups and minimize differences within groups.”

Home Health Quality Metrics tool can help LeadingAge Home Health members better understand their ratings.