This email may be of interest to those with Medicare.
“Home health” is a Medicare benefit that few people seem to know about — unless you or a loved one ends up in the hospital or a rehab facility, and are then ready to be discharged to home again. If there’s a skilled need — RN, therapy (PT, OT, ST), or social worker — Medicare pays for a skilled professional to go to someone’s home to provide services. The person must be unable to leave their home, except to see an MD or attend a gathering in their faith community. When the “skilled need” is resolved or when a therapy cap is hit, the benefit ends. An MD must authorize “home health.”
As of July 2015, Medicare has started to provide quality ratings — one to five stars — to home health agencies in the US. Nine thousand home health agencies around the US were rated. Only 239 agencies in the US received five stars. In California, 1004 agencies were rated, with 42% receiving 4 or 5 stars.
The Medicare home health agency ratings aren’t super-easy to find but, after digging a layer or two down on the Medicare website, they can be discovered. Start at the Medicare home page of “Home Health Compare”:
www.medicare.gov/homehealthcompare/search.html
A Kaiser Health News (KHN) article notes:
“Medicare applied the new quality measure to more than 9,000 agencies based on how quickly visits began and how often patients improved while under their care. Nearly half received average scores, with the government sparingly doling out top and bottom ratings. … The ratings are based on agencies’ assessments of their own patients, which the agencies report to the government, as well as Medicare billing records. The data is adjusted to take into account how frail the patients are and other potential influences.”
“There was a wide variation in scoring among types of providers, a Kaiser Health News analysis found. Visiting nurse associations and agencies with religious affiliations tended to get the most stars. Home health agencies run out of skilled nursing homes and agencies run or paid for by local governments tended to perform poorly.”
“The star ratings were designed to capture overall quality by summing up the results of nine of 27 measures Medicare already publishes on its Home Health Compare website. Agencies were evaluated by how quickly they started visiting a patient, whether they explained all the drugs a patient was taking either to the patient or their caretaker and whether they made sure a patient got a flu shot for the season. The agencies also were judged on how much their patients improve in skills like walking, getting in and out of bed, bathing, breathing and being able to move around with less pain. Finally, the agencies were rated on how many of their patients ended up going to the hospital. The current star ratings are based on performance from the fall of 2013 through the end of last year. Medicare will reassess the stars quarterly.”
“Some in the home health industry are welcoming the ratings, but there is concern that consumers will interpret the scores differently than Medicare intends. The government considers three stars to be solid performers, but in rankings for restaurants, hotels and other common services, three stars are often interpreted as mediocre. … Another concern is that many of the quality results are self-reported by home health agencies.”
You can find the full Kaiser Health News article (July 16, 2015) here:
khn.org/news/home-health-agencies-get-medicares-star-treatment/
A more recent KHN article notes that the ratings have another limitation:
“Bill Dombi of the National Association for Home Care and Hospice says that for one, they emphasize improvement. ‘The population in home health tends to be fairly aged with multiple chronic illnesses, where stabilization may be the goal rather than improvement,’ he said. Dombi said it’s unrealistic for a patient with Parkinson’s disease, for example, to get much better. But home health can help that person maintain some independence.”
Here’s a link to the more recent article (September 18, 2015):
khn.org/news/how-one-home-health-agency-earned-five-stars/
Robin