Choosing a Home Health Agency: The New Star Rating System for Medicare Home Health Care

Medicare beneficiaries sometimes need skilled medical care to stay in their own homes, or as part of post-hospitalization rehabilitation. For example, an individual might need physical therapy to address a mobility issue that is causing the person difficulty with self-care. Or, a patient who has been treated in the hospital for a serious infection might need to have intravenous medications delivered daily by a skilled nursing professional, even after discharge from the hospital. It is usually much less expensive, for both the patient and for Medicare, to receive these services at home rather than at a long term care facility or rehab hospital. Authorized home health care agencies can provide these services to patients and enable them to stay at home. It’s a win-win situation–provided that the home health agency is a good one. But not all of them are.

For a number of years, the Center for Medicare and Medicaid Services (CMS) has collected data from home health agencies on wide variety of quality measures that determine whether a home health agency is providing good service to Medicare beneficiaries. These quality measures include such factors as whether the agency timely initiates the prescribed care, whether it provides education to patients regarding their medications, and whether the home care has resulted in actual improvement of the patient’s mobility, pain, and other indicators of good health. CMS also looks at whether a patient who has received home health care from an agency later needs to be hospitalized due the condition being treated.

Earlier this month, CMS announced its new Star Rating System for home health agencies. CMS has added a new “ratings tool” to its existing home health care website that allows consumers easily to compare Medicare-authorized home health agencies in their area so that they can choose the best agency for their needs. The website, located at CMS Home Health Compare (https://www.medicare.gov/homehealthcompare/), allows a Medicare beneficiary to enter a location (city/state or zip code) to find home health agencies in his/her area, and then select up to three agencies for comparison. The rating system is a 1 (worst) to 5 (best) system that uses the variables mentioned above to calculate each agency’s rating.

One disturbing truth about home health care in Minnesota is that more than half of all home health agencies here are rated at 2.5 or below–one of the worst overall ratings average in the nation! Even worse, not a single Minnesota agency received a rating of 5! Many agencies aren’t rated at all, so there is no way to determine what quality of care those agencies provide. Thus, it’s important that, when selecting a Medicare home health agency, beneficiaries use the ratings website to find one that has the best possible rating. Choosing a good home health agency can mean the difference between receiving good services at home, or a trip to the hospital.

Want more information about this topic? Check the following:

CMS.gov/Home Health Star Ratings
Home Health Agencies Get Medicare’s Star Treatment (Kaiser Health News)
Medicare.gov/Home Health Compare