The public now can evaluate Medicare-certified home health agencies using a five-star system, with the ratings posted online as of Thursday. While the vast majority of HHAs received around three stars, as expected, the ratings also illuminate some aspects of the industry that might be more surprising—including which states are top of the pack and which have the fewest top-rated providers.
The Home Health Compare Quality of Patient Care Star Ratings are based on an agency’s relative performance on nine quality measures tracked by the Centers for Medicare & Medicaid Services (CMS), including timeliness of care and frequency of hospital admissions. They are similar to the CMS star ratings for nursing homes and other providers.
“Adding star ratings to Home Health Compare is another step forward in our continuing efforts to empower consumers by providing more information to help them make health care decisions, while also encouraging providers to strive for higher levels of quality,” said Dr. Patrick Conway, acting principal deputy administrator for CMS and deputy administrator for innovation and quality, in a prepared statement.
The ratings are distributed according to a curve, meaning that the majority of agencies are in the middle-of-the-pack while five-star and one-star ratings are rarer outliers.
In fact, only six agencies received a single star in this first release, while 239 agencies received five stars, according to a Kaiser Health News analysis. More than 9,300 agencies nationwide received a rating, and 46% received three or three-and-a-half stars. The ratings are to be updated quarterly.
Home health providers and other industry stakeholders have expressed concern that consumers will not understand that, because they are comparative, they are different than star ratings used for hotels and other products.
While a consumer might view a three-star rating as mediocre, CMS takes a different view. The ratings distribution for this first round shows “a large proportion of home health agencies are performing reasonably well,” Dr. Kate Goodrich, director of CMS’ quality measurement program, told KHN.
When it comes to providers receiving four or more stars, Medicare beneficiaries in certain states will have more options, KHN determined. These are the states where a third or more of rated HHAs scored four or more stars:
- New Jersey
- Rhode Island
- South Dakota
- District of Columbia
Written by Tim Mullaney