Patient Satisfaction Evaluation Tools

The idea of this initiative was to allow patients to make more informed decisions and stimulate providers to improve home health care quality. This initiative was launched in nursing homes in November 2002 as the Nursing Home Quality Initiative. The initiative was expanded to home health care and hospitals in 2003.

 

The Agency for Healthcare Research and Quality (AHRQ) called for survey items and measures on the quality of home health care in 2006 and developed a draft survey instrument, which was field tested in 2008. This finalized instrument was endorsed by the National Quality Forum and approved by the United States Office of Management and Budget (USOMG) in 2009. The Centers for Medicare & Medicaid Services (CMS) initiated the national implementation of the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS – pronounced HH-Caps) in 2009-2010. Reports of results were published starting in April 2012. In 2012 the Home Health Prospective Payment System or HHPPS was linked to quality reporting. Quality reporting was required of all Medicare-certified home health agencies serving 60 or more patients. Smaller agencies were able to apply for exemption status.

 

The HHCAHPS was designed to measure patient experience in Medicare-certified home health agencies. The goals included the following:

-To produce comparable data on the patient’s perspective that allows objective and meaningful comparisons between home health agencies on domains that are important to consumers.

-Public reporting of survey results to create incentives for agencies to improve quality of care.

-Public reporting to enhance public accountability in health care by increasing transparency in return for public investment.

In order to receive the annual payment update or APU, home health agencies must contract with an approved HHCAHPS Survey vendor to administer the survey on a monthly basis. Just as in other settings, home care has a patient satisfaction and clinical outcomes rating system as a part of an updated CMS Home Health Agency (HHA) Compare program, called Home Health Compare. [Data sets are available for download at https://data.medicare.gov/data/] The data sets are a subset of the Outcome and Assessment Information Set (OASIS), which includes data from home health agencies for Medicare and Medicaid reimbursed care for adult patients. The current version is the OASIS-C2, which was implemented in 2017. Star ratings were added in 2015 to Home Health Compare on Medicare.gov to assist consumers in making home health care decisions.

 

The latest 2018 and 2019 complete updates on home health prospective payment systems and quality reporting requirements are available in the Federal Register at the link shown on this slide.

 

Star Ratings 

The Star Ratings mentioned on the previous slide give consumers a way to compare home health agencies side-by-side. There are 23 individual ratings on which patients are asked to rate their experience with their agency, and results are compiled by CMS and posted on Medicare.gov’s Home Health Compare web site.

Eight of the 23 ratings have to do with quality of care as perceived by the patient, and the “Patient Satisfaction rating” is a summarization of these eight ratings (shown by the stars at the top of the chart). Only five of the individual ratings are shown here because we are limited by the size of the slide. Consumers can go on the website and sort the data based on what is important to them, then compare multiple agencies on the same criteria.

The site says that most agencies have ratings that are average, meaning their overall ratings fall in 3 to 3 ½ star range. 

Other Information

The site also helps consumers with making a choice by telling general information like:

The agency’s name, address, and phone number.

When they received their Medicare certification.

What type of agency are they (profit, government, non-profit).

What type of services they offer (nursing care, physical therapy, occupational therapy, speech therapy, medical/social services, and/or home health aide services).

This slide shows the same search criteria as the previous slide, but showing the general information these select agencies offer.