Home Health Compare was created because the Affordable Care Act (ACA) mandates that healthcare consumers have access to a comparison tool that provides transparent information about the quality of care provided by Medicare-certified home health agencies nationwide. The Home Health Care Compare website features a star rating system that gives each home health agency a score of between 1 and 5 stars. The methodology for calculating an agency’s star rating is very complex and is based on information derived from both the OASIS data set and the HHCAHPS (Home Health Consumer Assessment of Healthcare Providers and Systems) survey. Agency star ratings are instrumental in helping patients make “informed decisions” about their own care options. In addition, the data can be used internally by agency administrators to help guide quality and performance improvement efforts.
How is the OASIS used to calculate the Home Health Compare Star Rating?
CMS pulls specific performance and functional indicators from OASIS data sets as part of the star rating calculation. These 7 individual outcome measures include:
- How often the agency initiated patient care in a timely manner
- How often the patient improved with managing their oral medications
- How often the patient showed improvement in ambulation
- How often the patient showed improvement in the ability to transfer in/out of bed
- How often the patient showed improvement in bathing themselves
- How often the patient showed improvement in dyspnea
- How often the patient required acute care hospitalization
In order for OASIS data to impact an agency’s star rating, the patient must have been discharged within the 12-month reporting period for which information is being reported, regardless of the episode start date. In addition, the agency must have reported data for 5 of the 7 outcome measures listed above. CMS compares how a patient was scored at start/resumption of care to how they were scored at discharge. Learn more about the importance of an accurate discharge HERE.
This data is then used to calculate if the patient showed an improvement or a decline and essentially scores agencies on the quality of care that was delivered. Note that for all measures, except acute care hospitalization (ACH), a higher measure value equates to a better score. For ACH, a lower measure translates to a better score.
Want to improve your star ratings and outcomes? Schedule a meeting to learn more.
How is the HHCAHPS Survey used to calculate the Home Health Compare Star Rating?
The HHCAHPS survey is designed to provide feedback from the patient/caregiver perspective. The survey can be completed by the patient or their proxy and is composed of 34 questions. There are 25 “core questions” and 9 “about you” questions on the HHCAHPS. The survey questions focus on:
- Care of patient
- Communication between providers and patients
- Specific care issues
- Whether the patient would recommend the agency to someone else
Data submitted via the HHCAHPS is analyzed, calculated, and forwarded for public reporting by a CMS contractor. Once survey results are combined with OASIS data to create a composite score, quality star ratings are updated on the Home Health Care Compare website. These updates are published quarterly. This frequent transparency encourages agencies to address specific areas that may need improvement and allows agencies to ensure the information shared about their care centers accurately shines to spotlight the excellent service that they deliver. Agencies can also use this information to review progress from quarter to quarter.
Using Home Health Compare to Improve Agency Outcomes
With the changes coming to the OASIS data set with OASIS-E and the implementation of the HHVBP (Home Health Value Based Purchasing) model on January 1, 2023, agencies should expect renewed interest from referral sources in Care Compare.
Here are steps you need to propel your agency’s ratings in a positive direction:
1. Regularly review your Care Compare Reports.
Set a calendar reminder for agency leadership to review and discuss agency data, as well as ensure that all data is accurate.
2. Identify your agency’s deficiencies
Trying to address every deficiency at one time will only lead to frustration. Celebrate the wins, big or small, and use that motivation to step up your QAPI (Quality Assurance/Performance Improvement) game.
3. Put a written plan in place
Focus on one measure at a time. We recommend starting with the ones where you can see quick improvement. Tackle the large projects that are lowering your overall star rating.
4. Foster teamwork to reach goals
Agencies are composed of individual professionals who have the patients’ best interests at the core of everything they do. Sharing where your agency ranks nationally often can serve as a huge motivator to get staff involved in improving outcomes. Encouraging staff to visit the Medicare Care Compare website for your agency can be a huge eye opener, as can reviewing the information together as a team. Communication is key to setting and reaching both short-term and long-term goals.
Staying abreast of industry changes and how those relate to agency operations is vital to maintaining compliance. When an agency consistently monitors where they fall on the national spectrum, they will consistently see growth and improvement in outcomes.
Want to improve your star ratings and outcomes? Schedule a meeting to learn more.
