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2019 Star Ratings Refresh – What to Expect and How to Improve

Product Specialist | Shield HealthCare
09/21/18  9:13 AM PST

Star Ratings

In accordance with the Affordable Care Act of 2010, the Centers for Medicare & Medicaid Services (CMS) is required to implement more transparent information about providers to assist consumers when selecting a healthcare provider. To do this the Star Ratings system on the Home Health Compare website keeps consumers informed while continuing to push standards of high quality care for Medicare patients.

CMS consolidates submitted data from OASIS and CAHPS surveys to report and calculate Star Ratings. As a result, the public can search through Medicare-certified home health agencies and view scores for Quality of Patient Care and Patient Survey Summary.

 Who qualifies for Star Ratings?

  • Nursing Homes
  • Physicians
  • Dialysis Facilities
  • Hospitals
  • Medicare Advantage Plans
  • Hospice Compare

Star Ratings Data and Measures

The majority of the data used for scoring is derived from OASIS and the rest from patient surveys. It proves important to not only aid patients to better health, but ensure good patient experience.

Process Measures – from CAHPS Surveys:

    1. Timely initiation of care
    2. Drug education on all medications provided to patient / caregivers
    3. Removed April 2018 – Influenza immunization received for current flu season

Outcome Measures – from OASIS Data:

    1. Improvement in ambulation
    2. Improvement in bed transferring
    3. Improvement in bathing
    4. Improvement in pain interfering with activity
    5. Improvement in dyspnea
    6. Increase or decrease acute care hospitalization rate

Tips on How to Improve your Star Ratings

Even though star ratings do not affect your agency’s reimbursement, the ratings are still important to maintain and improve. And since the scoring is updated quarterly, it’s possible to quickly and effectively improve your outcomes. Consequently, high ratings (3 or more stars) are marketable and can attract new patients.

  • Submit accurate OASIS data quickly. Use good practices to make sure the OASIS data being submitted on time and is error free. Learn how Shield HealthCare can help improve your OASIS scores here.
  • Make sure you have and effective CAHPS vendor that will get surveys to your patients in a timely manner. And make sure it is easy and efficient to upload data to the vendor.
  • Continually review and analyze reports as they come in. This will guide you to set and maintain internal measurable quality goals to help caregivers provide the highest quality of care possible. Setting your own standards high and checking on progress with raise your star ratings.

To learn more about the 2019 Star Ratings refresh – watch our webinar on strategies to improve your rating.

References:

Centers for Medicare & Medicaid Services 

National Conference of State Legislatures