Review of Home Care Star Rating

CMS established the Home Health Compare (HHC) website on Medicare.gov as a key tool for consumers to use when choosing a home health care provider.  CMS has now added “star ratings” to HHC in order to make the information there easier to use. The star ratings summarize some of the current measures of home health care provider performance that the site already offers, and will provide further support to consumers’ health care decision-making. Implementation of the new star ratings is now proceeding.

Quality of Patient Care Star Ratings are a summary of 9 of the quality measures based on OASIS patient assessments and Medicare claims data, published on Home Health Compare beginning July 16, 2015, and updated on a quarterly basis.  Quality of Patient Care Star Rating Provider Preview Reports showing the calculation of the July 2015 star rating were distributed to providers (via their CASPER folders on the QIES system) at the beginning of April.  CMS sponsored a webinar in March 2015 to review the format of the report. The slide deck, a sample report, and a link to view a recording of the webinar, as well as additional information on the Quality of Patient Care Star Rating, are posted on the Home Health Star Ratings web page . Providers wishing to review the initial Quality of Patient Care Star Rating as published on Home Health Compare in July should use this initial preview report.CMS logo

  • 3 Process Measures
    • Timely initiation of care
    • Drug education on all medications provided to the patient or caregiver
    • Influenza information received for the current flu season
  • 6 Outcome Measures
    • Improvement in ambulation
    • Improvement in bed transferring
    • Improvement in bathing
    • Improvement in pain interfering with activity
    • Improvement in shortness of breath
    • Increase or decrease in acute care hospitalization rate
Methodology of Star Rating- .pdf Webinar on 5 Star Home Care Rating

The Patient Survey Star Ratings is a separate set of star ratings that will be calculated from the patient experience of care measures, which are based on the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey data.  These are scheduled for publication on HHC in January 2016. CMS held a Special Open Door Forum (SODF) in May 2015 to describe the rationale for these star ratings and to give a detailed description of the methods for calculating the ratings and assigning stars.  The SODF presentation slides, Technical Paper, and FAQs are posted on the HHCAHPS web page . Questions or comments about the HHCAHPS Patient Survey Star Ratings can be submitted to: HHCAHPS@RTI.org.

Other Enhancements to the Home Health Quality Reporting Program

As of July 2015, two new NQF-endorsed quality measures will be added to HHC:

  • Rehospitalization During the First 30 Days of Home Health (NQF #2380)
  • Emergency Department Use without Hospital Readmission During the First 30 Days of Home Health (NQF #2505)

These measures were added to the CASPER reports in January 2014 and were originally scheduled to be published in 2014, but were deferred to coincide with other updates to HHC taking place in July 2015. Technical documentation on these measures and their risk adjustment models is available here.

Provider Preview Reports to be Published Quarterly. As of April 1, 2015, Home Health Agencies began to receive Provider Preview Reports (for all Process Measures and Outcome Measures) on a quarterly, rather than annual, basis. The second quarterly report has just been distributed to provider’s CASPER folders.

The opportunity for providers to review their data prior to public reporting aligns with our other quality reporting programs and the requirement for provider review under the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act). Specifically, the third phase laid out in section 2(e) of the IMPACT Act requires the public reporting of the measures implemented to satisfy the measure domains delineated within it.  Section 2(g) of the IMPACT Act sets forth the requirement of public reporting and that providers have an opportunity to review their data prior to public reporting.  For more information on the IMPACT Act of 2014 we refer readers to: http://www.gpo.gov/fdsys/pkg/BILLS-113hr4994enr/pdf/BILLS-113hr4994enr.pdf

NH Home Care Overall Star Ratings