Home Health Medicare News: Beginning January 2016, the Centers for Medicare and Medicaid (CMS) plan to roll out a new star ratings category that is primarily focused on feedback from patient phone surveys. The “Patient Survey Star Ratings” will be based on data from the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey, which is already utilized to gather data on the performance of caregiving facilities. Additionally, there are plans to create a star-rating system based on OASIS assessment and claims data.

The changes come amid concern expressed by many stakeholders who fear that consumers will not be aware of the fact that the star-rating system is distributed on a curve- where agencies are being compared to one another.

More information provided by CMS below:

Two types of star ratings

NEW! Patient Survey Star Ratings.  Many stakeholders have proposed that the patient experience of care measures, based on the HHCAHPS survey data, be reflected in the star ratings. CMS has been developing “Patient Survey Star Ratings” that are based on the patient experience of care measures, and these are now scheduled for publication on Home Health Compare in January 2016. CMS will host a Special Open Door Forum (SODF) about this new set of star ratings on Thursday, May 7, 2015 from 1:30 to 2:30 pm Eastern time.  This SODF will describe the rationale for the HHCAHPS Patient Survey Star Ratings and give a detailed description of the methods for calculating the ratings and assigning stars. It will also include a question and answer session.  Information about the SODF will be posted on the SODF webpage . The SODF presentation slides, Technical Paper, and FAQs will be posted on the HHCAHPS web page  and in the Downloads section below when they are available. Questions or comments about the HHCAHPS Patient Survey Star Ratings can be submitted to: HHCAHPS@RTI.org.

New name: Quality of Patient Care Star Rating (formerly “HHC Star Rating.”)  In order to distinguish the star rating based on OASIS assessments and claims data from the new Patient Survey Star Ratings, we have changed its name from “HHC Star Rating” to “Quality of Patient Care Star Rating.”  This should allow Home Health Compare users to more easily understand the data source for each star rating.

Quality of Patient Care Star Ratings Methodology

Which measures are included? - The Quality of Patient Care Star Rating methodology includes 9 of the 27 currently reported process and outcome quality measures. These measures were chosen based on the following criteria:

• The measure should apply to a substantial proportion of home health patients and have sufficient data to report for a majority of home health agencies.
• The measure should show a reasonable amount of variation among home health agencies and it should be possible for a home health agency to show improvement in performance.
• The measure should have high face validity and clinical relevance.
• The measure should be stable and not show substantial random variation over time.

The 9 measures selected based on these criteria are:

Process Measures:

1. Timely Initiation of Care

2. Drug Education on all Medications Provided to Patient/Caregiver

3. Influenza Immunization Received for Current Flu Season

Outcome measures:

4. Improvement in Ambulation

5. Improvement in Bed Transferring

6. Improvement in Bathing

7. Improvement in Pain Interfering With Activity

8. Improvement in Shortness of Breath

9. Acute Care Hospitalization

(Background information on the quality measures themselves is available via the “Home Health Quality Measures” link in the Useful Links section below.)

Which HHAs receive star ratings? -- All Medicare-certified HHAs are potentially eligible to receive a star rating. Currently, HHAs must have at least 20 complete quality episodes for data for each measure to be reported on HHC. (Completed episodes are paired start or resumption of care and end of care OASIS assessments.) Episodes must have discharge date within the 12-month reporting period regardless of admission date. To have a Quality of Patient Care Star Rating computed, HHAs must have reported data for 5 of the 9 measures used in the Quality of Patient Care Star Ratings calculation.  The current methodology for calculating the Quality of Patient Care Star Ratings can be accessed via the Related Links section below. This methodology will be updated periodically as additional refinements are made.

When will Quality of Patient Care Star Ratings be published? – Quality of Patient Care Star Ratings will be published on HHC beginning in mid-July 2015 and quarterly thereafter. The Quality of Patient Care Star Ratings will be updated each quarter based on the new data that are published on Home Health Compare.

Quality of Patient Care Star Rating Provider Preview Reports - Provider preview reports showing the Quality of Patient Care Star Ratings and rating calculations for each agency will be distributed to each agency approximately 3.5 months before the ratings are published on Home Health Compare.  Agencies have several weeks to review and request CMS review of their Quality of Patient Care Star Rating, provided that they can submit evidence that the data used to calculate the measures were inaccurate or incomplete to the extent that their star rating was affected. 

 The full announcement can be viewed here