Data reveal that a disproportionate percentage of agencies received 5 stars in Miami, which has a reputation for being a hotbed of fraud.
 
In Miami, 22.6% of agencies that received quality of care star ratings earned 5 stars, according to an HHL analysis of April 2018 data on CMS’ Home Health Compare.
 
By comparison, 5.2% of agencies nationwide that received quality of care star ratings earned 5 stars. And 10.1% of Florida agencies that qualified earned 5 stars.
 
CMS has a moratorium on new home health agencies and new branches of existing home health agencies in Miami, Houston and four other metropolitan areas. Among all cities nationwide, only Miami and Houston had 10 or more 5-star agencies in quality of care.
 
CMS’ 5-star ratings for home health were designed to make clear to the average person what agencies stand out in terms of quality of care and patient satisfaction. But it’s possible for agencies to exploit the system since, for instance, quality of care data comes from agencies’ assessments of their own patients.
 
Several measures used in five-star ratings also are included in the value-based purchasing model, which is ongoing in nine states including Florida. 
 
 
April 2018 star ratings in quality of care broken down by nation, Florida and Miami
 
There are 460 5-star agencies nationwide, and 28 of those agencies are in Miami, according to an analysis of CMS data.
 
Nation
Florida
Miami-Dade
 
Miami
5 stars
460
83
35
28
4.5 stars
1,025
166
36
22
4 stars
1,372
198
47
28
3.5 stars
1,706
142
35
13
3 stars
1,668
127
30
16
2.5 stars
1,341
63
18
10
2 stars
915
31
9
6
1.5 stars
371
12
2
1
1 star
43
1
1
0
Total agencies with star ratings
8,901
823
201
124
Source: Home Health Compare