Home Health & Hospice Week

CAHPS methodology leads to big fluctuation in 5-star ratio.

If you haven’t checked your Home Health Compare ratings lately, they may have changed.

The Centers for Medicare & Medicaid Services updated the site with new data in April, the agency’s Lori Teichman noted in CMS’s May 4 Open Door Forum for home care providers.

The percentage of home health agencies that received HHCAHPS (patient survey) star ratings and earned five stars dropped to 17.5 percent in this latest update, compared with 37.5 percent of agencies in January, a CMS official confirms to Eli.

Comparison: Only 3 percent of HHAs received five-star ratings for Quality of Patient Care, notes consulting firm Fazzi Associates on its website.

“There is no forced distribution of the [HHCAHPS] star ratings, so each quarter there are fluctuations in the cutpoints that make up the four measures for the summary star rating,” the CMS staffer explains. “This means that one quarter for the Care of Patients measure, for example, a score of over 97 might correlate to 5 stars. Whereas the next quarter a score of 96 might correlate to 5 stars.”

More changes ahead: “Since the summary star rating is an average of the four measures that make up the HCAHPS summary star rating — (1) Care of Patients; (2) Communications between Providers and Patients; (3) Specific Care Issues; and (4) Overall Rating of Care — this means that the summary star ratings for individual home health agencies will fluctuate from quarter to quarter,” the CMS source says.

For Home Health Compare measures in general, “nearly all measures showed improvement” in the April update, Fazzi notes.

Exceptions: “‘Influenza immunization received for current flu season’ decreased for the second reporting period in a row,” Fazzi points out. Four measures remained unchanged.

Note: More on CAHPS methodology is at www.medicare.gov/HospitalCompare/Data/Overview.html.