Modifications to the Quality of Patient Care Star Rating Algorithm for Home Health Agencies

By ShirleyAnn Janulewicz RN, BSN, PHN

Patient Care Star Rating is an important tool which encourages providers to strive for higher levels of quality care and helps direct overall health system improvement. Consumers can utilize this information, thereby empowering them to compare agencies and choose the best agency for their loved ones’ care.

In January, proposed changes include to remove the Influenza Immunization Received for the Current Flu Season based on the Outcome and Assessment Information Set (OASIS data), and to add a measure: Emergency Department use without hospitalization (claims-based data). Stakeholders support removal of the Influenza Measure, but do not support the addition of the Emergency Department use measure.

CMS held a meeting to obtain input from Medicare-certified home health agencies. They presented the background on the current Quality of Patient Care Star Rating Methodology, the 9 measures selected, and the criteria used for selecting these measures. Home health agencies must be able to report 5 of the 9 measures to have a star rating computed, which means 20 episodes in which each of these measures were utilized. During the meeting, graphs were used to demonstrate how the ratings of the July 2017 Home Health Compare went up slightly, regardless if they were small or large, rural or urban agencies, when the flu measure was removed.

This conference call was sponsored by CMS Medicare Learning Network (MLN). To review the event materials, visit the CMS MLN Events website, and select the event from the list. An audio recording and transcript will be available approximately 2 weeks after the event.