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Home Health Compare Will Launch - One Of These Days

Published on Fri Oct 31, 2003 Print Friendly and PDF PDF

Use the delay to prepare for scrutiny.

After several tentative dates and cancellations, it now looks as if the national launch of the Centers for Medicare & Medicaid Services' Home Health Compare Web site will take place in early November, and you should know by now if you'll feel like celebrating.

CMS plans to hold a press conference about the measure the same day the Home Health Compare Web site will go live.

The Web site will contain agency-specific outcome data for each Medicare-certified home health agency, reflecting care provided between June 2002 and May 2003 (see OASIS Alert, Vol. 4, No. 10, p. 96). The exact launch date will depend on the schedules of both CMS Administrator Tom Scully and Health and Human Services Secretary Tommy Thompson, who plan to be involved in the intense but brief publicity surrounding the home health quality initiative rollout.

CMS plans to accompany the launch with advertisements in newspapers in each state, a CMS spokesperson confirmed in the Oct. 7 Open Door Forum for home health. The ads will contain selected outcomes, a brief explanation of home care and where to find the Home Health Compare Web site.

In states with a large number of agencies, HHAs will be selected to appear in the ads based on a ranking by the number of unduplicated admissions for agencies within the state, the spokesperson explained. Then those agencies will be presented alphabetically.

The ads will focus on three outcome measures: improvement in bathing, improvement in ambulation and improvement in taking oral medications. These are the same outcomes highlighted in the Phase I pilot project of HHQI, which began last May.

All 11 outcomes will be on the Web site for public comparison (see OASIS Alert, Vol. 4, No. 10, p. 97). The 11 measures used in the quality comparison should remain the same for the next year, the spokesperson told forum listeners, but may change after that. After Jan.1, 2004, the National Quality Forum will evaluate the measure to see if they are the best ones to use.

In response to industry concerns, CMS presented a two-and-a-half-hour HHQI satellite and Web broadcast Oct. 3 and a special half-hour segment in the Oct.7 forum.

CMS emphasized key points HHAs should keep in mind when preparing for the HHQI launch:

  • Check your demographic information. Demographic data for the Web site comes from state survey records. Any errors in the agency name, address, phone number or services provided can be corrected by submitting a written request to your state OSCAR/ASPEN coordinator to update your records, CMS' Mary Weakland said in the Oct. 3 broadcast. CMS will update demographic data monthly, CMS' Karen Pace added, so it will take at least that long for your corrections to show up after you submit them to the state.

    If your coordinator is reluctant to correct the record between surveys, refer her to CMS' Sept. 11 memo (S&C- 03-33) instructing state survey agencies to do this, recommended a CMS official during the Oct. 7 forum.

  • Outcome data will change quarterly. The pilot project showed that outcome results didn't change significantly from month to month, so CMS will update this data on the site quarterly, Pace explained. With each update, the time period reflected in the data will move forward, she said. So with the first quarterly update in January, the data will cover episodes from November 2002 through October 2003. Then in April the 12-month time period covered by the data will move forward three more months.

  • Even home health agencies have outliers. Agencies with fewer than 20 episodes in the 12-month period reflected in the data will not have data published on the site. Instead, to avoid misleading consumers and to protect patient privacy, the site will tell viewers there are too few episodes to calculate the data for public reporting.

    Agencies with less than six months of data will be on the site, but the numbers will show up only when six months of data is available. CMS will include a statement explaining the shorter time period.

    Also, CMS will cite outcome results of "under 5 percent" or "over 95 percent" with those phrases, rather than with specific numbers, to protect patient privacy.

  • Correct ZIP codes are important. Users will find it difficult to search for a local agency to serve them unless agencies are more careful in completing M0060, Weakland warned listeners. In the OASIS User's Manual, the response-specific instructions for M0060 (patient zip code) tell HHAs to "enter the zip code for the address of the patient's CURRENT residence" - in other words, the address where the patient is receiving home care services from you now. Don't enter the code for the patient's permanent address or the agency's corporate offices, or your agency will show up as serving that location - even if it's on the other side of the country.

    Editor's Note: Consumers and referral sources will be able to view Home Health Compare at www.medicare.gov/HHCompare/home.asp. To see the archived HHQI broadcast on the Web, go to http://cms.internetstreaming.com. More details on the quality initiative are at www.cms.hhs.gov/quality/hhqi/default.asp. The Sept. 11 memo is at http://www.cms.hhs.gov/quality/hhqi/Correction Policy.pdf.

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