Medicare Compliance & Reimbursement

Widespread errors with administrative data on the soon-to-be-unveiled Home Health Compare Web site will make checking that site a must for all home health agencies, once it's up and running.

Any day now, the site will begin comparing three patient outcomes for HHAs in eight pilot states. But it also will list administrative data - name, address, phone number, services provided, initial date of certification and type of ownership - for all agencies nationwide, the Centers for Medicare & Medicaid Services said in the Open Door Forum last month on the home health quality initiative.

For agencies in the eight pilot states, CMS furnished a data preview and the patient outcomes data appears accurate, state home health representatives tell Eli. But unfortunately, those previews have shown widespread problems with the administrative data, says Pat Kelleher with the Home & Health Care Association of Massachusetts.

The most problematic of the issues relates to contracted therapy staff, explains Gene Tischer with Associated Home Health Industries of Florida. In their licensure applications, HHAs have three choices to check for each type of discipline furnished: provided by employed staff, provided by contracted staff, or provided by both types of staff.

CMS' software is not picking up the contracted staff option when it lists the services provided by an agency, and so is omitting that service for agencies who checked that choice, continues Mary Schantz with the Missouri Alliance for Home Care. "It's a technical glitch," Schantz explains.

That means many HHAs that use contracted therapists will show up as not furnishing therapy services unless the administrative data is corrected, Tischer points out. If patients or referral sources check such an agency out on the Web site, they may pass it over if they need therapy.

All agencies, not just pilot state ones, should check their administrative data as soon as possible, urged CMS in the HHQI forum. HHAs should report errors to their state licensing departments, Tischer notes. Quality Improvement Organizations handle reports of patient outcomes data errors.

Due to the administrative problems and the time it may take agencies to submit corrections, Tischer is calling for CMS to put a disclaimer on the Home Health Compare site explaining that the services listed may not be inclusive.

But CMS plans to have the glitch fixed by the time it launches the Web site, promises a CMS spokesperson.

The exact debut date for the Web site and newspaper ads trumpeting pilot state HHAs' patient outcomes won't be decided until the last moment, but it should be about May 1.

Many HHAs are not ready for the public scrutiny of their outcomes, Tischer predicts. In Florida, 50 agencies still haven't downloaded their outcome-based quality improvement (OBQI) reports listing their patient outcomes for the first time, he stresses, let alone prepared themselves for the ad campaign.

"No one's really prepared for it," he expects. Many are counting on the assumption that the release of outcomes may not have much effect, as has been perceived in the nursing home and managed care markets.

On the other hand, Keely Fagen with the South Carolina Home Care Association maintains agencies in her state are ready to face the music.

There are always some agencies that are behind the curve, but many have worked hard on preparing for the HHQI project, Schantz says. The Missouri association and QIO, MissouriPRO, have worked together to get the word out about the project for a year. And MAHC recently offered a free conference on handling the media attention surrounding the HHQI launch, Schantz adds.

Missouri HHAs are "pretty positive" about the initiative, she says. "It's just one more tool consumers can use to choose an HHA."

Home Health Compare will be available at www.medicare.gov.