The Centers for Medicare & Medicaid Services (CMS) has launched the Provider Data Catalog and enhanced Medicare’s Compare sites, including Care Compare, to improve access to healthcare quality information. A key feature of Medicare’s Care Compare website is the home health star ratings system, designed to assist consumers in selecting a home health care provider. This user-friendly tool on Medicare.gov offers an official and convenient source for evaluating provider quality.
Navigating Home Health Choices with Star Ratings on CMS Care Compare
To simplify the process of choosing a home health agency, CMS Care Compare utilizes “star ratings”. These ratings summarize complex performance measures, presenting them in an easily digestible format for consumers. Think of them as a quick snapshot of a provider’s quality. While star ratings are a valuable tool, it’s important to remember they are one component of the comprehensive quality information available on Care Compare. Consumers are encouraged to explore all available data to make informed healthcare decisions.
The Methodology Behind Home Health Star Ratings on CMS Compare
CMS understands the significance of the data presented on Care Compare for home health agencies, stakeholders, and individuals seeking care. Therefore, the development of the home health star ratings involved a transparent process, ensuring that all voices were heard:
- Stakeholders were given opportunities to understand the development process.
- Input was actively sought to ensure Care Compare reflects the needs of its users and those affected by it.
CMS is committed to open communication and shares information through various channels. The current calculation and reporting of star ratings are a result of stakeholder feedback and rigorous data analysis. The system is designed to be dynamic, with ongoing refinements anticipated. CMS encourages users to review the information and provide feedback to further improve the home health star ratings.
Types of Home Health Star Ratings Available on CMS Care Compare
Within CMS Care Compare, you’ll find two distinct types of home health star ratings, each providing a different perspective on agency performance:
- Quality of Patient Care Star Ratings: These ratings focus on objective measures of care quality.
- Patient Survey Star Ratings: These ratings reflect the experiences of patients receiving care from the agency.
Deep Dive into Quality of Patient Care Star Ratings
The Quality of Patient Care (QoPC) Star Rating is derived from OASIS (Outcome and Assessment Information Set) assessments and Medicare claims data. CMS initially introduced these ratings in July 2015 and provides quarterly updates on Care Compare as new data becomes available.
To be eligible for a Quality of Patient Care Star Rating, Medicare-certified Home Health Agencies (HHAs) must meet specific data reporting criteria. Agencies need data for at least 20 completed quality episodes for each measure to be evaluated on Care Compare. These episodes are defined by the start or resumption of care and end of care OASIS assessments, with the episode ending within the 12-month reporting period. Furthermore, HHAs must report data for a minimum of 5 out of the 7 measures used in the QoPC Star Rating calculation to receive a rating. The detailed methodology for calculating the Quality of Patient Care Star Rating is available for download, and CMS commits to updating this methodology as improvements are implemented.
Prior to public release on Care Compare, HHAs receive Provider Preview reports approximately 3.5 months in advance. These reports detail the agency’s Quality of Patient Care Star Ratings and the underlying calculations. This preview period allows agencies to review their ratings and submit evidence of calculation errors for CMS review. CMS conducted a webinar on March 26, 2015, to explain the report format and the review process. Sample reports and webinar materials are accessible in the Downloads section for further information.
Understanding the Measures in Quality of Patient Care Star Ratings
The Quality of Patient Care Star Rating methodology incorporates both process and outcome quality measures already publicly reported on Care Compare. These measures are carefully selected based on several criteria:
- Broad Applicability: They should apply to a significant portion of home health patients and have sufficient data for most agencies.
- Meaningful Variation: The measures should demonstrate variation in performance across agencies, allowing for improvement.
- Validity and Relevance: They must be clinically relevant and easily understood.
- Stability: Measures should be consistent over time and not subject to random fluctuations.
- Adaptability: Measures are reviewed and updated based on ongoing analysis, expert input, and stakeholder feedback.
Currently, the 7 measures included in the Quality of Patient Care Star Rating are:
- Timely Initiation of Care (process measure)
- Improvement in Ambulation (outcome measure)
- Improvement in Bed Transferring (outcome measure)
- Improvement in Bathing (outcome measure)
- Improvement in Shortness of Breath (outcome measure)
- Improvement in Management of Oral Medications (outcome measure)
- Potentially Preventable Hospitalization (outcome measure)
Exploring Patient Survey Star Ratings on CMS Home Care Compare
Patient Survey Star Ratings on CMS Compare are based on the patient experience of care, gathered through the Home Health CAHPS (Consumer Assessment of Healthcare Providers and Systems) Survey. Introduced in January 2016, CMS updates these ratings quarterly and provides comprehensive information on the HHCAHPS website.
Similar to QoPC ratings, all Medicare-certified HHAs are eligible for Patient Survey Star Ratings. However, agencies must have at least 40 completed surveys within a four-quarter reporting period to receive a rating. Agencies with fewer surveys will still have their HHCAHPS data reported on Care Compare, but without star ratings. This 40-survey threshold ensures statistical reliability for star rating calculations. Detailed information on the Patient Survey star rating methodology can be found on the HHCAHPS survey website.
HHAs also receive Provider Preview reports for Patient Survey star ratings, approximately one month before public release. This allows agencies to review their ratings and dispute any calculation errors.
Measures Included in Patient Survey Star Ratings
The Patient Survey star ratings on Care Compare utilize four key measures derived from the HHCAHPS survey:
- Care of Patients (Survey items: Q9, Q16, Q19, and Q24)
- Communication Between Providers and Patients (Survey items: Q2, Q15, Q17, Q18, Q22, and Q23)
- Specific Care Issues (Survey items: Q3, Q4, Q5, Q10, Q12, Q13, and Q14)
- Overall Rating of Care Provided by the Home Health Agency (Q20)
The “Willingness to Recommend” item is not included in the star rating as its results closely mirrored the “Overall Rating of Care.”
Further Resources for CMS Home Health Star Ratings and Care Compare
For additional questions or feedback regarding home health star ratings and CMS Care Compare, please use the following contact points:
- Patient Survey Stars & Home Health CAHPS: Visit the HHCAHPS website or call 1-866-354-0985.
- Quality of Patient Care Star Ratings: Email [email protected].
- Formal Review Requests for Quality of Patient Care Star Ratings (including data suppression requests): Email [email protected].
Important Privacy Note: Do not include identifiable patient information in any correspondence, such as medical record numbers, dates of birth, or Protected Health Information (PHI) as defined by HIPAA.
Refer to the Downloads section on the original CMS page for more in-depth resources, including sample preview reports, calculation methodologies for OASIS and Medicare claims-based measures, and a Frequently Asked Questions document, which is regularly updated. Your questions and comments are valuable and can be submitted to [email protected].
By utilizing Cms Home Care Compare and understanding home health star ratings, consumers can confidently navigate their home care choices and select providers committed to quality and patient experience.
