CMS will add five Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) measures to its star ratings of home health agencies that will be available to view by the public on the Home Health Compare website in January 2016.
CMS will assign a star rating to care of patients and to communication between providers and patients. It also will add a star rating to “Specific care issues” composite HHCAHPS measures as well as the “Overall rating of care provided by the agency” global measure, CMS said in a May 7 special open door forum on the topic. The fifth addition will be a Survey Summary Star Rating, which is an average of the other four measures.
A “Willingness to recommend” measure was not included because CMS says it considers it too similar to the overall rating for usefulness in the rating system.
CMS will issue a sample HHCAHPS Star Ratings preview report to agencies in October 2015 (see link below); it will not be viewable to the public and will include data from patients served from April 2014 through March 2015.
Data for the measures for the HHCAHPS Star Ratings are based on the same HHCAHPS measures publicly reported on the Home Health Compare website, as it will be with the other quality measures slated for public consumption through a star-rating system viewable by the public in July, CMS says. The first HHCAHPS Star Ratings will be based on responses collected from patients from July 2014 to June 2015.
The two star-rating systems will be separate, however.
Also, agencies will receive a star rating of 1 to 5 with the HHCAHPS Star Ratings, while they’ll earn half-star ratings for quality measures. CMS explained in the forum that there was not enough distinction between agencies for half-star ratings for the HHCAHPS measures.
Also, for the HHCAHPS Star Ratings, CMS will use all survey responses to the HHCAHPS survey and then convert those into linear scores on a zero- to 100-point scale. That’s different than Home Health Compare HHCAHPS scores, which report “top box” or only positive responses.
CMS will also attempt to level the playing field for HHCAHPS Star Ratings scores for agencies with varying patient mixes by adjusting for patient characteristics that are known to affect responses, the federal Medicare agency says.
For instance, patients who live alone tend to give lower scores on HHCAHPS surveys, CMS says.
CMS also will consider these patient adjustment factors: Age, education, self-reported overall health status, self-reported mental/emotional status, a diagnosis of schizophrenia or dementia, a survey answered by proxy and the language in which the survey was completed.
Sample five-star distributions
CMS used data collected from July 2013 to June 2014 to see what agencies would receive and found that for the “Care of patients” measure, 28.4% of 5,797 agencies earned three stars, 39.3% earned four stars and 14.3% earned five stars. Only 2.6% of agencies earned one star.
For the communication measure, 36% earned five stars, 41.9% earned four stars and 1.7% earned one star. For the “overall” rating, 9.4% earned five stars, 33.5% earned four stars and 41.1% earned three stars, while 2.3% earned one star.