Agencies Post Strong Quality Numbers But Patients Not Wowed

Home health agencies across the country continue to step up on quality of patient care, but that doesn’t mean that more patients are enthusiastic about their providers, judging by the latest round of Home Health Compare data.

National averages have improved for nearly all the quality of patient care measures that the government tracks and posts online for Medicare home health providers, according consultancy firm Fazzi Associates, based in Northampton, Massachusetts. This data is updated quarterly on the Home Health Compare website maintained by the Centers for Medicare & Medicaid Services (CMS). Fazzi analyzed the latest Home Health Compare update, which occurred on Monday.

On a national basis, all measures associated with managing daily activities showed improvement, and all measures associated with treating wounds and preventing pressure sores showed slight improvement, according to Fazzi.


Four measures related to managing pain and treating symptoms improved, while pain assessment conducted stayed static. The only dip came in the preventing harm category, where there was a decline in influenza immunization received for current flu season.

The latest update for the quality of patient care measures reflects data collected between Jan. 1, 2015, and Dec. 31, 2015.

For the measures related to unplanned hospital care, the latest data was collected between Oct. 1, 2014, and Sept. 30, 2015. The national average for urgent, unplanned emergency room care worsened slightly this quarter, from 12.3.% to 12.4%. The acute care hospitalizations number was unchanged quarter-over-quarter, at 16%.


Agencies receive a Five Star rating based on nine quality measures. The national average star rating remained the same, at 3.0. Drilling down to the state level, there were fluctuations. In California, for example, the state’s top 20% of agencies now average 4.5 stars, up from 4.0 stars in the previous quarter, Fazzi data show.

CMS also surveys consumers on their experiences with home health agencies, through the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Of the five CAHPS measures, the national average for “patient willingness to recommend the HHA to family and friends” declined from 79% to 78%.

This is “the first time in a long time” that this particular measure has declined, Fazzi noted Tuesday in an email sharing its analysis.

A separate Five Star rating is generated for an agency based on its CAHPS scores.

Potential disconnects between high-quality care and patient enthusiasm has been highlighted in the past by the sometimes stark difference between an agency’s two different star ratings.

Written by Tim Mullaney

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