Start Small for Big Home Health Star Ratings

It’s only natural that home health care companies would want to do everything possible to boost their star ratings, given that they are being scrutinized by potential patients and referral sources.

But home health agencies shouldn’t bite off more than they can chew, according to the panelists who took part in Tuesday’s webinar on Quality of Patient Care Star Ratings, put on by Home Health Care News and sponsored by Homecare Homebase.

For instance, once an agency learns its star rating, there can be a natural tendency to want to start a continuous quality improvement (CQI) project to improve a quality measure that might be holding down the rating, according to Gina Mazza, director of regulations & compliance at home care and hospice consulting firm Fazzi Associates. But in reality, that is a great time to step back and assess employees’ competency levels with OASIS, she explained. That’s because if the coding process itself is not done to the highest standards, it’s impossible to even get an accurate picture of where improvement is most needed.


Along those same lines, when setting out to improve an agency’s rating, it’s best to not address every single quality measure at the same time, according to Michele Berman, director of rehabilitation at BAYADA Home Health Care, a privately-held, New Jersey-based home care company that operates in 21 states.

“There are really two common mistakes: setting too many goals and not setting any goals,” Berman explained. When it comes to improving quality measures, BAYADA uses an approach based on the law of diminishing returns, she said.

For example, if a team sets its sights on two or three goals, it’s likely to achieve all of them with excellence, Berman said. But if a team sets between four and 10 goals, it’s likely to only achieve one or two of them with excellence.


“The more goals you try to juggle at once, the less likely you’ll be able to reach them,” Berman said.

Still, that’s not to say home health agencies should go ahead and ignore the majority of quality measures in favor of focusing just on two or three. Instead, agencies should determine the areas that are truly their most problematic, while also continuously tracking all of their other quality measures, said Scott Pattillo, vice president of product management and strategy at Homecare Homebase.

“All nine of the measures that make up the star ratings can be measured and analyzed,” he said.

This measurement can come in the form of real-time data from the field, Pattillo explained. Having such data at hand—and the ability to analyze that data—can inform an agency’s decisions around where to focus at any given time, and what to do first, Pattillo explained.

“You can’t improve what you can’t measure,” he said.

Thus, the ability to gather and manage data, and to train staff to use necessary technology, is absolutely key to achieving success in the star ratings, Mazza said. Home health employees at all levels have to buy into the project.

“If we can look at what we’re doing and try to get [employee] buy-in based on what we’re doing—patient care—and show that this is an advocacy effort, I think that really honestly helps with buy-in,” Mazza said.

Home health care workers already have the passion to enact meaningful change, the panelists agreed.

“It’s just a matter of putting the data in the hands of people, educating them as to why it matters, how it translates to better outcomes to patients,” Pattillo said. “If you put those tools and processes into place, people naturally rally around that.”

Written by Mary Kate Nelson

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