The Centers for Medicare & Medicaid Services (CMS) hosted a Special Open Door Forum call today to solicit stakeholder input for adding a five-star rating system for home health agencies (HHA) and review the proposed methodology for calculating the ratings. The rating will appear on the Home Health Compare website similar to that currently found on the Nursing Home Compare, no sooner than summer 2015.
The star rating system is a continuation of the rollout of the star rating system across all the Meidcare.gov Compare websites. The goal of the star rating system is to simplify consumer evaluation of key quality measures to help them differentiate the quality of care among healthcare agencies and make more informed selections. An additional goal is to assist home health agencies identify potential areas for improvement and, ultimately, improving the transparency of healthcare. There are currently star ratings on Nursing Home Compare, Physician Compare, and the Medicare Advantage Plan Finder, with Dialysis Facility Compare and Hospital Compare proposed for 2015 as well.
All Medicare-certified HHA are eligible to receive a star rating; however, the following are also required:
- A minimum of 20 complete episodes (complete episodes are paired start/resumption of care and end of care OASIS assessments)
- Episodes with discharge dates within the 12-month reporting period
- Data for 6 of the 10 process and outcome measures
CMS is proposing the following ten process and outcome quality measures for utilization in the star rating methodology:
| Process Measures | Outcome Measures |
|---|---|
| 1. Timely Initiation of Care | 5. Improvement in Ambulation |
| 2. Drug Education on all Medications Provided to Patient/Caregiver | 6. Improvement in Bed Transferring |
| 3. Influenza Immunization Received for Current Flu Season | 7. Improvement in Bathing |
| 4. Pneumococcal Vaccine Ever Received | 8. Improvement in Pain Interfering With Activity 9. Improvement in Dyspnea 10. Acute Care Hospitalization |
All of the current 27 process and outcome measures were reviewed utilizing these conditions in order to be included in the list above:
- The measure should apply to a substantial proportion of home health patients and have sufficient data to report for a majority of home health agencies.
- The measure should show a reasonable amount of variation among home health agencies and it should be possible for a home health agency to show improvement in performance.
- The measure should have high face validity and clinical relevance.
- The measure should be stable and not show substantial random variation over time.
Moving forward, CMS will review the comments from consumers and stakeholders, continue technical analysis and refine the proposed star rating methodology. They may also hold additional Open Door Forums to continue dialogue. Home Health Agencies are encouraged to review the resources provided by CMS to become more familiar with the star rating system and its potential impact their operations, provide comments to HHC_Star_Ratings_Helpdesk@cms.hhs.gov and continue to build a culture of quality within their organization.
This is a further step in measuring the quality of care provided by healthcare organizations and underscores the need for HHAs to ensure they are leveraging technology to provide insight into all aspects of their agency operations and decision making.
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