CMS will implement its new 5-Star rating system on Home Health Compare using half-star increments instead of the full-star increments as previously discussed. The system will start in July and be published quarterly thereafter.
 
The federal Medicare agency said in a Special Open Door Forum Feb. 5 it made the change in response to industry concern that many home health agencies would likely earn three stars under the rating system.
 
Using 2013 data, 24.3% of agencies would receive three stars, 24.2% would get a 3.5-star rating, 15.8% would receive a 2.5-star rating and 16.1% would receive four stars.
 
The July star ratings will reflect OASIS data from January through December 2014 and claims data from October 2013 through September 2014 — the same reporting period that will be published on Home Health Compare in April, CMS says.
 
CMS says agencies will see a preview of their star rating and how it was derived in Certification And Survey Provider Enhanced Reports (CASPER)  reports before it is posted for the public to view about the end of March.
 
And while CMS says its selection of measures that will go into the star ratings will remain the same, it says it does plan to evaluate and refine the system over time and may include new or different measures in the future.
 
In response to comments that the ratings system should also include Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) data, CMS says it is developing a star ratings methodology for this data that could eventually be combined with quality measure data.
 
CMS has extended the comment period for the rating system through Feb. 13. Send questions or comments to HHC_Star_Ratings_Helpdesk@cms.hhs.gov.
 
Measures used to rate an agency
 
An agency’s score (five being the best) would be based on 10 of the 27 process and outcome quality measures currently reported on Home Health Compare, CMS says.
 
Process measures include: Timely initiation of care, drug education on all medications provided to patient/caregiver, influenza immunization received for current flu season and pneumococcal vaccine ever received.
 
Outcome measures include: Improvement in ambulation, improvement in bed transferring, improvement in bathing, improvement in pain interfering with activity, improvement in dyspnea and acute care hospitalization.