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CMS’s Home Health Care Ratings

Aug 6, 2015

In today’s world of shopping for goods and services, there is a plethora of websites and applications that can assist the consumer in narrowing down their choices by providing an abundance of information. This information includes historical and financial facts about the company producing the goods or services and, most importantly, user reviews and feedback from consumers who have already purchased/utilized the goods or services. Popular examples of these websites/applications include Trip Advisor and Angie’s List.

In health care, consumers utilize similar website and applications (examples include ZocDocs and WebMD) when choosing a health care provider. Centers for Medicare and Medicaid Services (“CMS”) also provides consumers with their own version of reviews and ratings for Medicare providers through resources such as Physician Compare and Hospital Compare, grading these providers utilizing CMS’s “Five Star Rating System.”

CMS has created a similar resource to assist Medicare/Medicaid recipients in choosing home health care. Recently, and for the first time, CMS published their “star ratings” on Home Health Compare, CMS’s public information website for Home Health Agencies.

Two recent articles on CMS’s website, “CMS Releases First Round of Home Health Compare Quality of Patient Care Star Ratings”  and “Special Notice Regarding the Second Round of Quality of Patient Care Star Rating Provider Preview Reports”  go into great detail regarding these ratings. The first article reviews the measures utilized in grading the home health agencies as well as the first “round” of ratings provided on home health care agencies. The second article talks about the forthcoming release of “the second round” of scores to be published in October 2015 as well providing a “provider Preview report.”

According the first CMS article, “Star ratings can help consumers more quickly identify differences in quality and make use of the information when selecting a health care provider. In addition to summarizing certain data about Home Health Agency performance for consumers, star ratings can also help the agencies identify areas for improvement.”

Some of the measures each home health care agency will be graded on include 

  • How often the home health team began their patients’ care in a timely manner;
  • How often the home health team made sure that their patients have received a flu shot for the current flu season; 
  • How often the home health team taught patients (or their family caregivers) about their prescribed drugs;
  • How often home health patients got better at bathing; and
  • How often home health patients’ breathing improved.

This is another great step by the Department of Health and Human Services (“HHS”) to better equip today’s patients with the transparency and information they/their caregivers require when choosing their health care providers

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Steven Bisciello

Steven Bisciello is a Health Care Services Group, Partner experienced in revenue enhancement programs, health care litigation, compliance and physician practice management.

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