Greater Proportion of Home Health Agencies Earn 5-Star Rating

About 5% of U.S. home health agencies earned a 5-star rating for quality of patient care in the latest update to the Home Health Compare website, which occurred on April 11. That’s an uptick from 4% as of January 2018.

The percentage of 4.5-star agencies also increased in that time period, from 10% to 12%, according to an analysis of the data from Fazzi Associates, a consulting firm specializing in home health and hospice.

The Centers for Medicare & Medicaid Services (CMS) first launched the Quality of Patient Care star ratings on the Home Health Compare website in July 2015. The ratings were based on nine measures of care quality and were set to be updated on a quarterly basis. With this latest quarterly refresh, the “influenza immunization received for current flu season” measure was dropped.


The national average rating has remained at 3.5 stars, according to Fazzi. The ratings are designed to be distributed along a curve, meaning that the majority of providers would always fall in the middle of the pack—which agencies have protested as confusing to consumers.

In terms of performance on specific quality measures, “improvement in bed transfer” jumped the most, up 1.3%, according to Fazzi. “Improvement in management of oral medications” and “improvement in dyspnea” both improved at least 1%.

Though the acute care hospitalizations measure improved again, the frequency of “urgent, unplanned care in the emergency room” use worsened slightly, increasing 0.1% to hit 12.9%.


Fazzi is still evaluating potential causes for the uptick in emergency room use, Gina Mazza, a partner at the firm, told Home Health Care News. It is possible that the severe flu season played a role.

“I’m also interested to see if the trend continues or changes, to help identify some root causes,” Mazza said.

States bordering the Gulf of Mexico are among the strongest performers, with 83 5-star agencies in Florida, 27 in Alabama, 18 in Louisiana, and 48 in Texas.

Agencies in these states have also improved significantly in recent quarters, to break into the five-star club. Florida had 61 5-star agencies as of Oct. 2017, Louisiana had nine, and Alabama had six, Fazzi data show.

CMS also updated the consumer satisfaction measures gleaned from the survey known as the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS). National HHCAHPS averages remained the same quarter-to-quarter.

Written by Tim Mullaney

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