Choosing the right home health care provider can feel overwhelming. Fortunately, resources like Medicare.gov’s Care Compare
Understanding Medicare.gov Care Compare
Medicare.gov Care Compare is the official CMS website, serving as a central hub for consumers seeking information on various healthcare providers. Specifically for home health care, Care Compare aims to be your go-to, official source for assessing provider quality. It moves beyond just listing agencies, offering tools like “star ratings” to summarize complex performance data in an easily digestible format. Think of these star ratings as a quick snapshot of an agency’s performance, designed to empower you in your healthcare journey. While star ratings are incredibly helpful, remember that Care Compare also provides a wealth of other quality measures and details to explore for a comprehensive understanding.
Alt text: Medicare.gov Care Compare website homepage logo. Navigate to find and compare healthcare providers using star ratings and quality measures.
How Home Health Star Ratings Are Developed
CMS understands the significance of the data presented on Care Compare for everyone involved – home health agencies, stakeholders, and especially consumers like you. Therefore, the development of home health star ratings follows a transparent process, ensuring that all voices are heard. This commitment to transparency means:
- Stakeholder Input: CMS actively seeks and incorporates feedback from various stakeholders to ensure the ratings are relevant and meaningful.
- Data-Driven Approach: The methodologies behind star ratings are based on rigorous data analysis and are continuously refined over time.
CMS believes in open communication and encourages ongoing feedback on the star ratings. This iterative approach ensures that Medicare.gov home health compare remains a valuable and evolving resource.
Types of Home Health Star Ratings on Medicare.gov
Medicare.gov home health compare features two distinct types of star ratings, each providing a unique perspective on agency performance:
1. Quality of Patient Care Star Ratings
These ratings offer insights into the actual care provided by home health agencies. They are calculated using data from:
- OASIS Assessments: The Outcome and Assessment Information Set (OASIS) is a standardized assessment tool used for adult home health patients.
- Medicare Claims Data: Information derived from billing claims submitted to Medicare.
CMS updates these Quality of Patient Care Star Ratings quarterly, reflecting the most recent data available on Care Compare. Initially introduced in July 2015, these ratings provide a measure of how well agencies deliver care.
To receive a Quality of Patient Care Star Rating, agencies must meet specific data reporting criteria. This includes having data for at least 20 completed “quality episodes” for each performance measure. These episodes are defined by periods of care initiated and concluded with OASIS assessments within a 12-month reporting period. Furthermore, agencies need to report data for at least 5 out of the 7 measures used in the rating calculation.
Prior to public release on Care Compare, home health agencies receive “Provider Preview Reports.” These reports, issued approximately 3.5 months before the public posting, allow agencies to review their calculated ratings and identify potential calculation errors. This preview period ensures accuracy and allows agencies to request reviews if necessary.
2. Patient Survey Star Ratings
These ratings reflect the patient’s perspective on their care experience. They are derived from the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey. First launched in January 2016 and updated quarterly, these ratings capture patient satisfaction.
Similar to the Quality of Patient Care ratings, Patient Survey Star Ratings also have a data volume requirement. Agencies must have at least 40 completed HHCAHPS surveys over a four-quarter reporting period to receive these ratings. Agencies not meeting this threshold will still have their HHCAHPS survey data published on Medicare.gov home health compare but will not receive star ratings. This minimum survey number ensures the statistical reliability of the ratings.
Home health agencies also receive Provider Preview Reports for Patient Survey Star Ratings, roughly one month before public posting, allowing for review and error correction requests.
Measures Included in Home Health Star Ratings
To ensure the star ratings are meaningful and reflect key aspects of home health care quality, CMS carefully selects the measures included in each rating type. These measures are chosen based on several criteria:
- Broad Applicability: Measures should apply to a significant portion of home health patients and have sufficient data available for most agencies.
- Meaningful Variation: Measures should demonstrate variation in performance across agencies, highlighting differences in care quality.
- Potential for Improvement: Agencies should be able to improve their performance on these measures, incentivizing quality enhancement.
- Clinical Relevance and Validity: Measures must be clinically meaningful and accurately reflect the quality aspect they are intended to assess.
- Stability: Measures should be stable over time and not subject to random fluctuations.
- Evolving Nature: Measures are reviewed and updated based on ongoing analysis, expert input, and stakeholder feedback.
Quality of Patient Care Measures
The 7 measures currently used in the Quality of Patient Care Star Rating are:
- Timely Initiation of Care (Process Measure): Ensures care begins promptly after referral.
- Improvement in Ambulation (Outcome Measure): Measures progress in patients’ ability to walk.
- Improvement in Bed Transferring (Outcome Measure): Assesses improvement in patients’ ability to move in and out of bed.
- Improvement in Bathing (Outcome Measure): Tracks progress in patients’ ability to bathe themselves.
- Improvement in Shortness of Breath (Outcome Measure): Monitors improvement in managing breathing difficulties.
- Improvement in Management of Oral Medications (Outcome Measure): Evaluates progress in patients’ medication management skills.
- Potentially Preventable Hospitalization (Outcome Measure): Measures the rate of hospitalizations that could potentially have been avoided with better home health care.
Patient Survey Measures
The Patient Survey Star Ratings incorporate four key areas from the HHCAHPS survey:
- Care of Patients: Reflects patient ratings on survey items Q9, Q16, Q19, and Q24, covering aspects of direct patient care.
- Communication Between Providers and Patients: Based on survey items Q2, Q15, Q17, Q18, Q22, and Q23, focusing on effective communication.
- Specific Care Issues: Addresses specific care concerns through survey items Q3, Q4, Q5, Q10, Q12, Q13, and Q14.
- Overall Rating of Care Provided by the Home Health Agency: A global assessment of care quality captured in survey item Q20.
The “Willingness to Recommend the HHA” item is not included in the star rating calculation because its results closely mirrored the Overall Rating of Care.
Accessing More Information and Support
For further details and assistance regarding Medicare.gov home health compare and star ratings, you can reach out to the following resources:
- Patient Survey Stars & Home Health CAHPS: Visit 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: Please refrain from sending any Protected Health Information (PHI), such as patient medical records, dates of birth, or service dates, via email or mail.
For downloadable resources, including sample preview reports, methodology documents, and Frequently Asked Questions, refer to the “Downloads” section on the original CMS webpage where this information was sourced.
By utilizing Medicare.gov home health compare and understanding star ratings, you are taking a proactive step towards making informed decisions about home health care, ensuring access to quality services that meet your unique needs.
