5-Star Rating System for Home Health Agencies

Recently, the Centers for Medicare and Medicaid Services (CMS) proposed a star rating system under Medicare for home health agencies (HHAs) in 2015 which will help consumers judge the quality before selecting on a healthcare provider.

According to the proposal, home health agencies would be rated from 1 to 5 stars on the quality measures. At present, the CMS reports 27 process, outcome, and patient experience of care quality measures on Home Health Compare. The star ratings are publicly displayed on Nursing Home Compare, Physician Compare, and the Medicare Advantage Plan Finder currently. They are soon scheduled to be displayed on Dialysis Facility Compare and Hospital Compare as well.

How the Star Ratings Work

The proposed star rating methodology for use on Home Health Compare includes 10 of the 27 currently reported process and outcome quality measures.

Process Measures  Outcome Measures 
Timely Initiation of Care Improvement in Ambulation
Drug Education on all Medications Provided to Patient/Caregiver Improvement in Bed Transferring
Influenza Immunization Received for Current Flu Season Improvement in Bathing
Pneumococcal Vaccine Ever Received Improvement in Pain Interfering With Activity

Improvement in Dyspnea

Acute Care Hospitalization


All Medicare-Certified HHAs Will Be Eligible To Receive a Star Rating

At present, home health agencies are required to have at least 20 complete quality episodes for data on a measure to be reported on Home Health Compare. To have a star rating computed for Home Health Compare, the agencies need to have reported data for 6 of the 10 measures used in the calculation. For more information on how it works, read the CMS Fact Sheet.

In the meantime, check out ProfEdOnDemand’s Home Health training conferences on latest updates and coding fix-ups to avoid errors that could result in losses.

Source: The CMS

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