Medicare Compliance & Reimbursement

More than 1,200 home health agencies in eight states now have eleven patient outcomes posted on the Internet for all the world to see, and the rest of the nation won't be far behind.

"Home Health Compare," Medicare's Web site comparing patient outcomes by home health agency, went live May 1 as the Centers for Medicare & Medicaid Services kicked off its home health quality initiative. The site lists administrative information for each Medicare-certified HHA in the eight pilot states and patient outcomes in three columns: the agency's, the state average, and the Phase I states' total average.

CMS ran 16 newspaper ads in the Phase I states, covering only the largest HHAs in each area.

Letting small agencies sidestep public scrutiny by omitting them from the ads should have very little effect on how agencies react to the home health quality initiative, believes Gene Tischer with the Associated Home Health Industries of Florida. "It's the Web site that counts" and that will serve as a resource to referral sources and potential patients, he maintains. This site posts all Phase I agencies' outcomes.

Most states' Quality Improvement Organizations held a press conference that included CMS and state officials and home health industry representatives. The home health industry was able to use the HHQI launch as a way to educate the public about the home care benefit and what HHAs do, notes Pat Kelleher with the Home & Health Care Association of Massachusetts.

The media attention helped get across the basics, agrees Mary St. Pierre of the National Association for Home Care & Hospice. The industry's goal should be "to try to make home care more visible before the fractured hip," adds Bob Wardwell with the Visiting Nurse Associations of America.

Reporters in Massachusetts and Missouri, for example, rode along on home care visits when putting together their stories on the launch, say Kelleher and Mary Schantz with the Missouri Alliance for Home Care. Stories featuring home care descriptions ran in major newspapers including The Boston Globe, The Charlotte Observer, Orlando Sentinel and St. Louis Post-Dispatch and were picked up by the Associated Press and run in many smaller papers. The development also received radio and TV attention, Schantz notes.

HHAs were able to express a positive message about home care by staying positive about the HHQI project, says St. Pierre. And in Massachusetts at least, the idea that the outcomes on Home Health Compare shouldn't be used as the "sole determinant of an agency's quality" came through loud and clear, Kelleher says.

A statement from HHS Secretary Tommy Thompson echoed this important fact. "Seniors, people with disabilities and their families should consider this new data as one of many factors as they make a decision about choosing a home health agency," Thompson said in a statement.

Newspapers picked out a number of HHAs for special praise for having high outcomes. But at least one paper, The Boston Herald, also highlighted an agency that scored the worst on an outcome.

Much of the HHQI home care data was very close together, much more so than in the nursing home project launched last year, notes Ward-well. Beneficiaries may get the message that when only a few percentage points separate agencies, quality is good in all the organizations.

HHAs in New Mexico noticed a marked difference in outcomes between rural and urban agencies, reports Joie Glenn with the New Mexico Association for Home Care. That trend will bear investigating with the help of the QIOs, she comments.

Even if your HHA is not in one of the eight pilot states, Heather Rooney from Seattle-based Outcome Concept Systems recommends you go to the Home Health Compare Web site to check your administrative data.

"While your outcomes information will not be published until late fall, your agency's contact information, brief service description, ownership model, and date of Medicare certification have been published for public viewing," Roon-ey advises.

Referral sources or potential patients may use the site as a directory of home health agencies, and HHAs should make sure their information is accurate. CMS plans to extend the project nationwide this fall.

The Home Health Compare Web site is at www.medicare.gov.