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Reach for the Stars: the New Home Health Agency Star Rating System

Aimee Sharp
Author | Shield HealthCare
05/13/15  6:08 PM PST
Home Health Agency Star Rating

“Reach for the Stars: the New Home Health Agency Star Rating System” Originally published by Tortolano & Company in their Home Health Today (HHT) March/Early April 2015 Newsletter

Reach for the stars? You’d better, because starting this summer you won’t have a choice. CMS is putting the final touches on adding star ratings to Home Health Compare.

The ratings will include only 9 of the 27 quality measures currently included online. CMS selected the 9 measures based on high face validity and clinical relevance. The measures must also be ‘stable and not show substantial random variation over time’.

These are the 9 measures from Home Health Compare that will make up the star ratings:

  • Timely initiation of care
  • Drug education on all medications provided to patient and caregiver
  • Flu vaccination for current flu season
  • Acute care hospitalization
  • Improvement in:
    • ambulation
    • bed transferring
    • bathing
    • pain interfering with activity
    • shortness of breath

The one to five star rating your agency receives is going to be based on quality data you currently submit. Agencies to be included will be those that submit at least 20 complete episodes within a 12 month reporting period, and submit data that allows 5 of the 9 measures to be rated with the 5 star system. The first release of data will use data from calendar year 2014 (January 1, 2014 – December 31, 2014).

However, the rating for acute care hospitalizations will use data for completed episodes that occurred from October 1, 2013 to September 30, 2014. If you are one of the many agencies that has been focused on improving your hospitalization rate over the past year, you might be disappointed by your first rating. Future star ratings will be based on 12 month rolling reporting periods.

New information released with the formula for calculating star scores show some interesting methodologies. Star ratings will be based on half star (.5) increments, with the highest rating being 5 stars and the lowest 1 star. An overall score will be made available for each agency as well, based on the average of the 9 measures to be rated by the system.

Initial calculations from 2013 data shows that agency quality is distributed across each of the rating categories. Less than 1% of all agencies only received an overall rating of 1 star. 2.55% of all agencies received a 5 star rating with just over 8% receiving 4.5 stars. Almost 46% of all agencies fell into the 3-3.5 star rating.

Where will your agency fall in the ratings? Agencies are going to have preview of the star rating system in the next few days. CMS has stated that the reports are going to be made available this month and will be distributed to each agency.

When will the public see the star rating system? CMS’ targeted release date is mid-July. We will continue to keep you posted as news develops. – HHT

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