CMS Proposes Change in Star Rating Quality Measures

The Centers for Medicare & Medicaid Services (CMS) is proposing to switch a home health care quality measure that could help smaller agencies see a boost in star ratings.

Home health agencies receive a Quality of Patient Care (QoCP) star rating based on how well they perform on certain quality measures. The star ratings are designed to rank agencies on care quality and provide greater transparency and information for consumers.

The proposal seeks to eliminate the current Influenza Immunization Received for Current Flu Season measure and add an Emergency Department Use without Hospitalization measure. The move would swap an OASIS-based quality measure for a claims-based measure.

Currently, there are nine quality measures in the algorithm for QoPC star ratings on Home Health Compare, the CMS website where star ratings can be viewed for Medicare-certified home health agencies. To have a star rating computed, home health agencies must be able to report five of the nine measures.

The proposal comes as the influenza measure has affected home health rankings much more than other quality measures. In effect, it’s more inconsistent than other quality measures, CMS officials said during a call about the proposal on Thursday.

Fortunately for smaller home health agencies, replacing the measure could prove beneficial, according to CMS projections. The change could increase the average quality of patient care (QoPC) star rating of 3.03 to 3.06 on CMS’ scale of one to five.

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Home health star ratings have become increasingly important since the first were released on Home Health Compare in July of 2015, with one concern being that large providers have an edge due to their technology and other resources. Some of the biggest home health care providers have set their sights on receiving high star ratings.

Written by Amy Baxter

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