What Is A 5-Star Rating for Home Care?

The Centers for Medicare & Medicaid Services (CMS) first launched the Quality of Patient Care star ratings on the Home Health Compare (HHC) website in July 2015. All Medicare-certified home health care agencies (HHAs) are potentially eligible to receive a Quality of Patient Care Star Rating. Currently, HHAs must have at least 20 complete quality episodes for data for each measure to be reported on the HHC. Episodes must have an end-of-care date within the 12-month reporting period regardless of start date, according to the CMS. To have a Quality of Patient Care Star Rating computed, HHAs must have reported data for 5 of the 8 measures used in the Quality of Patient Care Star Ratings calculation

The eight measures that are part of the Quality of Patient Star Rating are as follows:

  • Timely Initiation of Care
  • Drug Education on all Medications Provided to Patient/Caregiver (this measure will be removed as of April 2019 with the Improvement in Management of Oral Medications will be added in its place)
  • Improvement in Ambulation
  • Improvement in Bed Transferring
  • Improvement in Bathing
  • Improvement in Pain Interfering with Activity
  • Improvement in Shortness of Breath
  • Acute Care Hospitalization

About 5% of U.S. home health care agencies earned a 5-star rating for quality of patient care in the April update to the HHC website, which represents an uptick from 4% as of January 2018. The percentage of 4.5-star agencies also increased in that time period, from 10% to 12%, according to an analysis of the data by a consulting firm specializing in home health and hospice. The national average rating has remained at 3.5 stars.

Part of the importance of the rating system is its simplicity for consumers: it highlights the important quality of care data and facilitates smart home health agency decisions. Top ratings also help referral sources and payer sources select the top agencies with whom they want to work. Top ratings can also boost an agency’s ability to recruit and retain qualified staff.

In addition, from an insurance point of view, a five-star rating indicates that the home health agency is committed to implementing strong loss-control protocols to mitigate risks and minimize losses. This, in turn, could mean fewer claims, a stronger risk profile, and better insurance rates when securing the various coverages needed to transfer risk.

About Manchester Specialty

Manchester Specialty provides total business insurance solutions for home health care agencies. We can help you provide the following insurance lines to your clients: General Liability, Professional Liability, Workers’ Compensation, Management Liability, Cyber Liability and Non-Owned & Hired Auto insurance, among other key coverages. For more information about how we can help you protect your insureds, please contact us at 855.972.9399.