Star Ratings & Quality Assurance: Plan Smart to Keep Your HHA Ahead

Home health agencies (HHAs) have been under an increased level of scrutiny lately, with an added emphasis on home health quality reporting. How you perform on quality measures drives data trends, calculates your 5-star ratings, and gives you much-needed data to develop and maintain your agency’s Quality Assurance and Performance Improvement (QAPI) plan.

By focusing on the right measures, you’ll improve your outcomes much more quickly and efficiently, says healthcare compliance expert J’non Griffin in her live webinar with ProfEdOnDemand. During her presentation on how to improve both your star ratings and your QAPI program, Griffin outlines which measures to select and which are no longer relevant for ratings. With the results of your performance publicly available, you’ll need to plan smart in order to remain a provider of choice.

8 Measures That Drive Star Ratings

Understanding how to improve outcomes through high performance on quality measures can be difficult because, well, there are so many of these measures. As mentioned in a previous post, to achieve a 4- or 5- star rating in the Quality of Patient (QoPC) Star Rating Program, you’ll need to report on 5 of the 8 measures used to calculate this rating. These 8 measures are:

  • Process:
    • Timely Initiation of Care
    • Drug Education on all Medications Provided to Patient/Caregiver
    • Influenza Immunization Received for Current Flu Season*
  • Outcome:
    • Improvement in Ambulation
    • Improvement in Bed Transferring
    • Improvement in Bathing
    • Improvement in Pain Interfering with Activity
    • Improvement in Dyspnea
    • Acute care hospitalization


*No Longer Needed: If you’ve been keeping up with HHA data reporting trends, you’ll notice that the process measure “influenza immunization received for current flu season” is no longer on the list – meaning that as of this month it will no longer have any impact on your star rating. This shouldn’t be cause for alarm, however, as CMS expects the lessened reporting burden to actually cause your scores to increase.

The Other Quality Measures

Focusing your efforts on achieving a 5-star rating is important, but your responsibilities don’t stop there. If you participate in Medicare, you are required to develop, initiate, and maintain a QAPI program, which is to be updated on an annual basis. Not doing so would violate the Conditions of Participation (COPs) and put your agency at serious compliance risk.

The first step in your program should be a QAPI plan, which you will use to monitor and implement certain quality measures, either measures already in existence or ones your agency creates. If your head is spinning from all this information – don’t worry. The measures you use can be inspired from those used to calculate your Star Rating, or they can be taken from the list of existing minimum data set (MDS) quality measures. Taking an existing measure and tweaking it to your agency’s needs is a great way to engage your staff and push to create more lasting change.

Focus Your Efforts to Achieve More

Although you’ll be tempted to fix everything at once, don’t be afraid to take your time in examining which measures your agency needs to focus on most. Determine if you want to focus first on where your agency is most vulnerable—or if you’ll tackle areas where just a little improvement will get you to spectacular service. Improve just one or two measures at a time, and work incrementally to tackle the other measures. By taking your time, you’ll be able to separate which measures define your star ratings and which push forward your QAPI program.

Remember: No agency is perfect, and even if yours currently has a 5-star rating, there are always areas of improvement. Don’t let a current 5-star rating cause you to push cruise control when creating or updating your QAPI plan. Always strive to provide higher quality care to patients under your care.

Most of all, says Griffin, ensure that your efforts to improve home health quality include both reactive and proactive elements. By implementing both styles, you’ll be better able to provide high quality care to your patients, leading to higher quality of life, increased patient satisfaction, and higher scores for your agency.

To join the conference or see a replay, order a DVD or transcript, or read more

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

error: Content is protected !!