Home Health Star Ratings
What are the home health star ratings?
We built the Home Health Compare (HHC) website on Medicare.gov as a key tool to help consumers choose a home health care provider. It’s designed to be an easy-to-access, convenient official source of information about provider quality. Sometimes, even the information on HHC can seem like “too much of a good thing” to consumers who have to make an urgent choice and there’s too much information and too many measures to consider.
We’ve started adding new tools to HHC to make the information easier to use, like “star ratings” that summarize some of the current health care provider performance measures. The star ratings give consumers another tool to help them make health care decisions, but we aren’t removing any of the information that’s always been on HHC.
How are the home health star ratings made?
Because we know the information posted on HHC is very important to home health agencies, other stakeholders, and consumers, we’re using a transparent development process to make sure all stakeholders:
- Have the chance to learn about how the star ratings were developed.
- Give input so HHC reflects those who use it or are affected by it.
We’ve been sharing information many ways. The way we calculate and report the star ratings now is based on input from stakeholders and ongoing data analysis. We expect the star ratings will evolve and be refined over time. We hope that you’ll review new information and will give us with input.
What are the types of home health star ratings?
There are 2 types of home health star ratings:
- Quality of Patient Care Star Ratings
- Patient Survey Star Ratings
The Quality of Patient Care Star Rating is based on OASIS assessments and Medicare claims data. We first posted these ratings on HHC in July 2015 and we’ll update them quarterly based on new data posted on HHC.
All Medicare-certified HHAs may potentially receive a Quality of Patient Care Star Rating. HHAs must have data for at least 20 complete quality episodes for each measure to be reported on HHC. Completed episodes are paired start or resumption of care and end of care OASIS assessments. Episodes must have an end-of-care date within the 12-month reporting period regardless of start date. To have a Quality of Patient Care Star Rating computed, HHAs must have reported data for 5 of the 8 measures used in the Quality of Patient Care Star Ratings calculation. The current methodology for calculating the Quality of Patient Care Star Rating can be accessed via the Related Links section below. This methodology will be updated periodically as additional refinements are made.
Each HHA gets provider preview reports showing the Quality of Patient Care Star Ratings and rating calculations about 3.5 months before the ratings are posted on HHC. Agencies have several weeks to review and send us proof that there’s been a calculation error to ask us to review their rating. On March 26, 2015, we sponsored a webinar to review the format of the report and the process for requesting review of the Quality of Patient Care Star Rating. You can also see a sample report illustrating the format of the Quality of Patient Care Star Rating Provider Preview Report and the slides from the webinar.
Which measures are included?
The initial Quality of Patient Care Star Rating methodology includes 8 process and outcome quality measures that are currently reported on Home Health Compare. These measures should:
- Apply to a substantial proportion of home health patients and have sufficient data to report for a majority of home health agencies.
- Show a reasonable amount of variation among home health agencies and it should be possible for a home health agency to show improvement in performance.
- Have high face validity and clinical relevance.
- Be stable and not show substantial random variation over time.
- Have changed over time based on the results of ongoing monitoring analyses, TEP input, and stakeholder feedback.
The 8 measures that are part of the Quality of Patient Star Rating are:
- Timely Initiation of Care (process measure)
- Drug Education on all Medications Provided to Patient/Caregiver (process measure) (This measure will be removed and the Improvement in Management of Oral Medications (outcome measure) will be added beginning with the April 2019 Home Health Compare refresh.)
- Improvement in Ambulation (outcome measure)
- Improvement in Bed Transferring (outcome measure)
- Improvement in Bathing (outcome measure)
- Improvement in Pain Interfering With Activity (outcome measure)
- Improvement in Shortness of Breath (outcome measure)
- Acute Care Hospitalization (claims-based) (outcome measure) We base the Patient Survey Star Ratings on the patient experience of care measures. We first posted these ratings on HHC in January 2016 and we post all information about the Patient Survey Star Ratings on the HHCAHPS website.
Where can I learn more about the home health star ratings?
Here’s who you can contact if you have questions or want to give feedback:
- Patient Survey Stars & Home Health CAHPS: email@example.com or call 1-866-354-0985
- Quality of Patient Care Star Ratings: firstname.lastname@example.org
HH Quality of Patient Care Star Ratings, including related preview reports and methodology for calculation using OASIS-based and Medicare claims-based measures:
All requests for formal review of Quality of Patient Care Star Ratings including requests to suppress data: HHC Star Ratings Review Request@cms.hhs.gov.
Please don’t send any identifiable patient information through the mail, including medical record numbers, dates of birth, service dates (including visit dates, admission dates, or discharge dates), or any other data items considered identifiers or Protected Health Information (PHI) under HIPAA.
October 30, 2018
Starting with the April 2019 Home Health Compare refresh, the QoPC Star Ratings will have the Drug Education on All Medications Provided to Patient/Caregiver during All Episodes of Care measure removed and the Improvement in Management of Oral Medications measure added. Provider Preview Reports will show these changes in January 2019. The data reporting period for this refresh will be July 1, 2017 to June 30, 2018 for OASIS-based measures and CY 2017 for the claims-based measure. These changes to the calculation algorithm were first presented during an MLN call on June 27, 2018, which was followed by a 30-day public comment period ending July 26, 2018. CMS summarized the public comments and announced final changes during an October 3rd, 2018 MLN call.
See the Medicare Learning Event slides. .For more information, please see the Medicare Learning Network event slides available here.
January 2, 2018
Home Health QRP: Transcript and Audio from Removal of Influenza Vaccination Measure from Quality of Patient Care Star Rating Webinar Available
An audio recording and transcript is now posted on the Home Health QRP Training webpage for the December 14, 2017 webinar on Removal of Influenza Vaccination Measure from Quality of Patient Care Star Rating.
December 13, 2017
A summary of public comments received in response to the proposed removal of the Influenza Immunization measure from the Quality of Patient Care star rating calculation is available in the downloads section. The public comment period was from October 11 to November 11, 2017. The comments received show support for this proposal and will be discussed during the December 14 HH QRP webinar on changes to the calculation algorithm and timeline.
November 03, 2016
QoPC TEP Update
A follow-up meeting of the Quality of Patient Care (QoPC) Technical Expert Panel (TEP) was held on September 20, 2016. The purpose of the webinar was to review the results of additional analysis recommended by the TEP, along with revised communication materials. The TEP summary, an updated sample preview report and a fact sheet for stakeholders have been added to the Downloads section below.
Special Open Door Forums –
- The first Quality of Patient Care Star Ratings Special Open Door Forum (SODF) was held on December 17, 2014 to present the proposed methodology for calculating the HHC Star Ratings and to get stakeholder input. The slide deck for this SODF is posted in the Downloads section below, A link to the transcript and audio recording of this SODF is included in the Related Links section below.
- A second Quality of Patient Care Star Ratings Special Open Door Forum (SODF) was held on February 5, 2015 to present a summary of stakeholder comments received and proposed revisions to the methodology, and to invite additional stakeholder input. The slide deck for this SODF is also posted in the Downloads section below, and a link to the transcript and audio recording of this SODF is also included in the Related Links section below.
Frequently Asked Questions (FAQs) – An updated FAQ document is included in the Downloads section below. This document is updated periodically as new comments and questions are received. You are encouraged to submit any questions or comments you may have about the star ratings to HomeHealthQualityQuestions@cms.hhs.gov.
- Special Open Door Forum (SODF), Thursday, February 5, 2015 – Transcript & Audio File (Zip File) - Adding Star Ratings to Home Health Compare Website – Special Open Door Forum [ZIP, 18MB]
- Special Open Door Forum (SODF), Wednesday, December 17, 2014 – Transcript & Audio File (Zip File) - Adding Star Ratings to the Home Health Compare Website [ZIP, 14MB]
- Home Health Quality Measures
- Home Health CAHPS
- Home Health Compare
- Qual_Pt_Care_Star16_sample_prvw_for_Apr2019 [PDF, 133KB]
- MLN QoPC Star Rating_508_20180924 [PDF, 267KB]
- MLN QoPC Star Rating_6_27_18 [PDF, 338KB]
- Quality-of-Patient-Care-Star-Ratings-FAQs-updated_for_Apr_2018 [PDF, 175KB]
- QoPC-Fact-Sheet-For-HHAs_for_April_2018 [PDF, 123KB]
- QoPC Methodology_for_April_2018 [PDF, 296KB]
- Star_rating_no_flu_Comment_Summary_20171121.pdf [PDF, 155KB]
- QOPC TEP Webinar Summary_20160920.pdf [PDF, 193KB]
- QOPC TEP Meeting Website Summary_v2 to CMS [PDF, 158KB]
- Wednesday, December 17, 2014 – Home Health Compare Quality of Patient Care Star Ratings, Special Open Door Forum – slide deck [PDF, 437KB]
- Thursday, March 26, 2015 – Home Health Compare Quality of Patient Care Star Ratings Provider Preview Report webinar – slide deck [PDF, 619KB]
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