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Delta Connect Blog

CMS' Home Health Five Star Rating System

Posted by Allison Kristofco on Apr 14, 2015 2:00:00 PM



Beginning in July of 2015, the Centers for Medicare & Medicaid Services (CMS) will be implementing a star rating system for home health agencies in the U.S.  This rating system will appear on the Home Health Compare (HHC) website and will be available to consumers at no charge. Although this information is already available online, this star rating system will summarize the current measures for health care provider performance and will allow consumers to compare data more quickly. Currently, visitors to the site can scroll through different categories and view check marks and comments in different areas of the home health agency’s offerings. The star rating system will streamline HHC, and will allow consumers to make the best decisions possible for their health care.

Medicare-certified home health agencies will be potentially eligible to receive a star rating.  Currently, there are more than 10,500 home health agencies in the United States, and approximately 12 million people are receiving home health care.  

The HHC Star Rating will include 9 of the 22 (10 of the 27) currently reported process and outcome quality measures. To start, Home Health Compare has two categories of measures: Process measures and Outcome measures. These measures were selected due to their matching of the following specific criteria:

  • The measure should apply to a substantial proportion of agencies, and there must be sufficient data to report on the quality of the agencies.
  • The measure should show a reasonable amount of variation among home health agencies, and agencies should be able to show improvement over time.
  • Each measure should have high clinical relevance.
  • Measures should be stable and not show substantial random variation over time.

Process measures center around the routine procedures that agencies perform and the success of these procedures. The Process measures that have been selected are:

  1. Timely Initiation of Care
  2. Drug Education on all Medications Provided to Patient/Caregiver
  3. Influenza Immunization Received for Current Flu Season

Outcome measures focus on the improvement of patient well-being in various categories. Since many patients who require home health care need assistance with everyday living activities, these categories are high in importance for agencies.  The Outcome measures that have been chosen are:

  1. Improvement in Ambulation
  2. Improvement in Bed Transferring
  3. Improvement in Bathing
  4. Improvement in Pain Interfering with Activity
  5. Improvement in Shortness of Breath
  6. Acute Care Hospitalization

CMS will provide agencies with the opportunity to preview their HHC Star Ratings before they are made available to the public each quarter. Agencies will have the ability to submit evidence if they believe that the data used to calculate their measures were either inaccurate or incomplete.

HHC will continue to help consumers find the best possible health care provider for their specific needs. Changes will be implemented as needed for the star rating system as it continues to move forward. 

Topics: Home Health Compare, home health agencies


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