Of the more than 9,300 agencies to receive stars on the quality ratings released in July, only 26% had reached four or five stars.
Those findings, speak to the concern over "patient satisfaction” in healthcare in general. One clinician put it this way during a conversation with the Atlantic last year: "Patients can be very satisfied and be dead an hour later."
As part of a broader federal push to summarize complicated statistical data into accessible information for patients, the CMS is releasing ratings for a range of health providers.
On Tuesday, the agency shared methodology behind hospital quality ratings that will be published this April. Similar efforts have been rolled out for nursing homes, physicians and dialysis centers.
The ratings for home health agencies will encourage facilities to strive for higher levels of quality and patient experience, said the CMS deputy administrator and chief medical officer, Dr. Patrick Conway, in an announcement.
The ratings come from patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey. It's very different from the quality rating released last year, which evaluates a completely different set of metrics.
The ratings measure two different aspects of care—the patient perspective and actual quality, a CMS spokeswoman said in an e-mail to Modern Healthcare. Consumers should look at the types of measures that are most important from their perspective to choose an agency that meets their needs.
But, confusion over the assessment is understandable, said William Dombi, vice president for law at the National Association for Home Care and Hospice. On quality, one home health agency is compared to all the others and an average is generated. “It is like a curve on a school test where the teacher gives the students with the average score a C, even if they scored a 50 on a 100 scale.” This is not a rating model that is commonly used in consumer star ratings, he said.
The patient satisfaction model, on the other hand, summarizes patients' overall responses to five questions about one facility, including whether the health team gave care in a professional way, communicated well and discussed medicines, pain and home safety. Another asked them to rank the provider on a scale ranging from zero (lowest) to 10 (highest).
It should also be noted that not every facility gets a rating. Of the more than 12,000 listed on the Home Health Compare website, only 5,743 received a star rating for patient satisfaction while 9,359 received one for the quality data released last year.
Federal analyses have also revealed other discrepancies in home healthcare. Data released in December found the average cost of delivering the service to Medicare beneficiaries fluctuated by hundreds of dollars from state to state, and that the government is paying significantly more for some bundled home-care services than others.