Home Health Blogger

Home Health Management - Issues with CMS "Star" Ratings

Posted by Nathan Hope on Apr 20, 2015

Medicare officials recently announced that the government-sanctioned “star rating” system for home health agencies would now include half-star increments. The additional partial increments come after concern was raised by providers regarding the ability for prospective patients and their families to get a fair overview of the agency’s performance overall.14-11-04-CMS

In December, CMS held a call with providers and home health management to explain the star ratings system and address any particular questions or concerns providers might have. The ratings system will be similar to the ratings system that are already in use for other types of providers such as nursing homes and hospice. The ratings system itself will be be based on certain categories of data that are already reported on directory websites such as Home Health Compare, and were proposed with the intention of providing a faster and more efficient way for consumers to get an idea of the provider’s quality of care.

After the February 5th call, CMS received enough feedback to determine that the ratings system should include the increments within the rating system in order to more accurately portray an agency’s performance. The original proposal would have automatically given 52% of home health providers three stars out of a possible five across the board. The half-star ratings system should expand the spread of 80% of HHAs to fall between 2.5 to 4 stars, rather than the previously more shallow and condensed ratings spread.

Many agencies are still opposed to the idea and worry that consumers may interpret the ratings incorrectly. One concern is that consumers will take, for example, a three-star rating and interpret it as an indication of mediocre care- when in fact it is just a star comparison based on the performance of other agencies nationwide. Another participant on the call suggested that the star rating should not be based on a curve system. “Describe this as Home Health Compare Ratings, not five-star,” he said. “This is a star rating that really is comparing agency to agency. If we ourselves can get out of the habit of [referring to] five-star, that is a first step.”

Other agency representatives took issue with the way the star ratings are determined. For example, some said that agencies will be rewarded for helping patients improve but not for helping them maintain their condition.

CMS will be acception additional comments from providers through Feb. 13th.

The ratings will be scheduled for release in July and be updated quarterly. Providers will receive a preliminary report with their star rating in March to give them time to dispute any information with CMS before the star ratings are published.

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