Home Health & Hospice

HHAs to see stars on Home Health Compare

Homecare Insider, December 15, 2014

Last Thursday, CMS announced that it will introduce a star rating methodology to Home Health Compare to enhance reporting on the quality of care delivered by home health agencies.
Home Health Compare, which consists of a large database of provider quality information, is billed as a user-friendly tool to help consumers choose an appropriate HHA for their care needs. However, because the volume of information the site aggregates can be overwhelming to sift through when someone is faced with an urgent need to choose a provider, CMS plans to add a five-star scoring scheme evocative of hotel ratings to the mix.
The move comes on the heels of a White House press release announcing that CMS will introduce a host of new and updated measures to boost transparency, data accuracy, and provider accountability surrounding the five-star quality rating system currently used on Nursing Home Compare, which has come under fire in recent months after a New York Times article alleged that CMS’ methods for collecting and scoring criteria for the ratings allows providers to game the system by inflating quality measures on self-reported data.
 The specific methodology for calculating and reporting star ratings for HHAs is still under development, CMS reports. There are currently 27 quality measures publicly reported on Home Health Compare, broken into three measure types: process, outcome, and patient experience of care. CMS is considering a subset of ten measures for star ratings based on their breadth of applicability, stability, meaningful variation among providers, and clinical relevance:
Process Measures
  1. Timely Initiation of Care
  2. Drug Education on all Medications Provided to Patient/Caregiver
  3. Influenza Immunization Received for Current Flu Season
  4. Pneumococcal Vaccine Ever Received
Outcome Measures
  1. Improvement in Ambulation
  2. Improvement in Bed Transferring
  3. Improvement in Bathing
  4. Improvement in Pain Interfering With Activity
  5. Improvement in Dyspnea
  6. Acute Care Hospitalization
According to CMS, the proposed methodology for calculating star ratings is based on a combination of individual measure rankings, as well as the statistical significance of the difference between the performance of an individual HHA on each proposed measure and that of all HHAs. An HHA’s quality measure values would be compared to national averages, and their rating adjusted to reflect the differences relative to other agencies’ quality measure values. These adjusted ratings would then be combined into one overall star quality measure star rating that summarizes each of the 10 individual measures.
All Medicare-certified HHAs will be eligible to receive a star rating. To have a star rating computed for Home Health Compare, HHAs must have reported data for 6 of the 10 measures used in the calculation. Currently, HHAs must have at least 20 complete quality episodes for data on a measure to be reported on Home Health Compare.
CMS plans to solicit stakeholder feedback on its proposed rating methodology, including the measures it seeks to include. The agency has scheduled a Special Open Door Forum (SODF) on December 17 to facilitate stakeholder dialogue. In addition, it has posted a preliminary Frequently Asked Questions document, which will be updated based on questions received, as well as more discussion of the proposed scoring methodology to its website. The methodology will be finalized based on feedback garnered through these channels and additional technical analysis, the agency states.
To read the full fact sheet, click here.
To access the FAQ document, click here.
To learn more about the upcoming SODF, click here.