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What's in A Star Rating?

Co-authored by the Alliance and Visiting Nurse Associations of America

Over the past few months, the Centers for Medicare and Medicaid Services' (CMS) introduction of patient experience survey star ratings to Home Health Compare, as a way to better understand the overall patient experience with care provided through Medicare-certified home health agencies, has gained a lot of media attention.

While the jury is still out on the star ratings as a whole, home health agencies recognize that both quality of care and patient experience are critical. Agencies are learning from the issuance of the star ratings and are committed to improving their performance on both quality of care and patient experience.

Outlined below, the Alliance and VNAA breakdown the top five takeaways from the Patient Survey Star Ratings:

  1. The new patient survey star ratings do not replace, but instead are in addition to, the Quality of Patient Care Star Ratings used to describe the quality of clinical care provided by a Medicare-certified home health agency.
  2. Health care is moving towards a system that rewards value over volume and more readily engages consumers; as such, performance data will become increasingly important.
  3. The Home Health Compare Star Ratings are the first step towards streamlining communication regarding home health quality and patient experience in a way that is digestible to health care consumers.
  4. The discrepancies in the patient and quality ratings among individual agencies stem from several factors, including the limitation of the Medicare home health benefit, as well as the understanding of skilled versus non-skilled home health health services. For example, Medicare home health care provides skilled, clinical care, not services such as meal planning and house cleaning. Unfortunately, there is a disconnect for many patients when those non-clinical service needs are not met by their home health care team, despite receiving excellent clinical care.
  5. The patient experience survey is a positive step in the right direction, and is essential to capturing the overall home health care experience, but CMS must refine its metrics to capture more accurate data.

As organizations committed to advancing home health care, the Alliance and VNAA stand ready to work with the Administration to perfect the use of patient survey data so that it is balanced with necessary quality data.

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