Home Health Compare Quality Charts Updated

The Home Health Compare results were updated on April 12, 2017.

Other than depression assessment conducted remaining unchanged, all national averages for the Quality of Patient Care measures showed improvement!  Most of the measures with the greatest improvement were those included in the Star Ratings.  The data collection period for these measures is from October 1, 2015 to September 30, 2016.

All quality measures included under Value-based Purchasing showed improvement except for urgent, unplanned care in the emergency room which remained the same, and acute care hospitalizations (collection period July1, 2015 to June 30, 2016).  The acute care hospitalizations measure has worsened slightly again for this quarter. This measure remained at 16.0% from January to July 2016 and worsened in October 2016 to 16.2%, to 16.3% in January 2017, and to 16.5% this data collection period.

All national averages for HHCAHPS measures remained the same as last quarter. The data collection period for these measures is from October 2015 to September 2016.

The national average for the Patient Care Star Ratings increased from 3.0 to 3.5 stars.

Visit our Home Health Compare page with drop downs to compare by state, by year, and by release date. You can also select comparisons for the top 10 percent or top 20 percent. We also provide a drop down to agency level for Star Ratings.

Medicare Home Health Agency Growth

{"type":"Bar","table":[["Year","Number of Medicare-Certified HHAs"],["2004",7651],["2008",9787],["2012",12311],["2014",12461],["2015",12346]],"options":{}}
{"type":"Table","table":[["Year","Number of Medicare-Certified HHAs"],["2004",7651],["2008",9787],["2012",12311],["2014",12461],["2015",12346]],"options":{}}

Sources: MedPAC March 2015; MedPAC June 2015 and 2016.

Medicare Hospice Agency Growth

{"type":"Bar","table":[["Year","Number of Medicare-Certified Hospices"],["2002",2323],["2008",3346],["2010",3509],["2012",3727],["2014",4092],["2015",4199]],"options":{}}
{"type":"Table","table":[["Year","Number of Medicare-Certified Hospices"],["2002",2323],["2008",3346],["2010",3509],["2012",3727],["2014",4092],["2015",4199]],"options":{}}

Sources: Medicare & Medicaid Research Review, 2013 Statistical Supplement and CMS/OIS/HCIS, Data from the Standard Analytical Files. Table 8.1; MedPAC June 2015. Table 12-3; MedPAC March 2017.

Home Health Compare Quality Charts Updated – January 2017

The Home Health Compare results were updated on January 26, 2017.

Nearly all national averages for the Quality of Patient Care measures showed improvement except multifactor fall risk assessment conducted which remained unchanged. Measures with the greatest improvement were diabetic foot care and patient education implemented and improvement in ambulation. The data collection period for these measures is from July 1, 2015 to June 30, 2016.

All quality measures included under Value-based Purchasing showed improvement except for the acute care hospitalizations which worsened slightly (collection period April1, 2015 to March 31, 2016). This measure remained at 16.0% from January to July 2016 and worsened in October 2016 to 16.2%, and then again to 16.3% this data collection period.

All national averages for HHCAHPS measures remained the same as last quarter. The data collection period for these measures is from July 2015 to June 2016.

Six measures were dropped from Home Health Compare public reporting this quarter per the final 2017 HH PPS rule; pain assessment conducted, pain interventions implemented, pressure ulcer risk conducted, pressure ulcer prevention included in the plan of care; pressure ulcer prevention implemented, and heart failure symptoms addressed.

Patient Care Star Ratings chartThe Patient Care Star Ratings showed an increase of agencies in the 2.5 star rating category, and an decrease in the number of agencies with 4.5 stars. The national average Star Rating remained the same at 3.0 stars.

Visit our Home Health Compare page with drop downs to compare by state, by year, and by release date. You can also select comparisons for the top 10 percent or top 20 percent. We also provide a drop down to agency level for Star Ratings.

Chronic Conditions Remain Costly and Preventable Leading Causes of Death

According to releases from the National Center for Health Statistics, the leading causes of death in 2014 remained the same as in 2013. However, age-adjusted death rates for five leading causes declined significantly; heart disease, cancer, chronic lower respiratory diseases, diabetes, and influenza and pneumonia. Although not in the top ten leading causes, hypertension also showed a significant decrease. Death rates increased significantly for unintentional injuries, stroke, Alzheimer’s disease, suicide, and chronic liver disease and cirrhosis between 2013 and 2014.

  • Generally, for younger age groups, external causes accounted for more deaths than other causes, whereas for older age groups, chronic diseases were far more prevalent than other causes.
  • For populations aged 65 and over, heart disease was the leading cause of death, followed by cancer. 
  • Heart disease was also the leading cause of death for the population aged 85 and over.
  • Alzheimer’s disease was one of the major causes of death at the oldest ages, ranking third for those aged 85 and over.
  • Medicare beneficiaries with six or more chronic conditions account for 15% of beneficiaries but 50% of total Medicare spending (see chart below).

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Clearly the data shows the impact of our aging population and chronic care needs. Fazzi uses the IHI Triple Aim framework when assisting agencies with preparing for the future now. To learn more about Triple Aim, click here.

To download a PDF of the top ten home health and hospice diagnoses from analysis of Fazzi claims data, click here.  To download a PDF of leading causes of death for three age groups; 65-74 years, 75-84 years, and 85 years and over, click here.  For chronic condition prevalence at state and county levels, click here.

Leading causes of death. For information on data and methods, including definitions of and procedures for ranking, see sources: Heron M. Deaths: Leading causes for 2014. National vital statistics reports; vol 65 no. 5. Hyattsville, MD: National Center for Health Statistics. 2016. Kochanek KD, Murphy SL, Xu JQ, Tejada-Vera B. Deaths: Final data for 2014. National vital statistics reports; vol 65 no 4. Hyattsville, MD: National Center for Health Statistics. 2016. Medicare spending on chronic conditions. See Centers for Medicare and Medicaid Services, chronic conditions charts: 2014.

 

Home Health Compare Quality Charts Updated – October 2016

The Home Health Compare results were updated on October 19, 2016.

Nearly all national averages for the Quality of Patient Care measures showed improvement with pneumococcal polysaccharide vaccine ever received and influenza immunization received for current flu season showing the most improvement. Only two measures remained the same; pressure ulcer risk conducted and depression assessment conducted. The data collection period for these measures is from April 1, 2015 to March 31, 2016.

All quality measures included under Value-based Purchasing showed improvement except for the Preventing Unplanned Hospital Care measures. The quality measures for acute care hospitalizations and urgent, unplanned care in the emergency room both worsened slightly this quarter (collection period January 1, 2015 to December 31, 2015).

All national averages for HHCAHPS measures remained the same as last quarter. The data collection period for these measures is from April 2015 to March 2016.

hhc-chart-10-16The Patient Care Star Ratings showed an increase of agencies in the 4.5 and 5 star rating categories, and an increase in the number of agencies with 1.5 to 2.5 stars. The number of agencies with 3, 3.5, and 4 stars decreased. The national average Star Rating remained the same at 3.0 stars.

Visit our Home Health Compare page with drop downs to compare by state, by year, and by release date. You can also select comparisons for the top 10 percent or top 20 percent. We also provide a drop down to agency level for Star Ratings.

Home Health Compare Quality Charts Updated – July 2016

The Home Health Compare results were updated July 18, 2016.

Nearly all national averages for the Quality of Patient Care measures showed improvement with only one measure showing a decline. The data collection period for these measures is from January 1, 2015 to December 31, 2015.

  • Overall Quality of Care Star Rating: Remained the same at 3.0 stars.
  • Managing Daily Activities: All measures showed improvement.
  • Managing Pain and Treating Symptoms: Four measures showed improvement and pain assessment conducted remained unchanged.
  • Treating Wounds and Preventing Pressure Sores: All measures showed slight improvement.
  • Preventing Harm: Depression assessment conducted remained unchanged. Influenza immunization received for current flu season showed a slight decline.

The data collection period for Preventing Unplanned Hospital Care is October 1, 2014 to September 30, 2015. The quality measure for acute care hospitalizations remained unchanged while urgent, unplanned care in the emergency room worsened slightly this quarter from 12.3% to 12.4%.

For HHCAHPS averages, the national score for patient willingness to recommend the HHA to family and friends decreased for the first time in a long time. If you have not already read our latest white paper, Key Drivers & Best Practices for Improving HHCAHPS Results, you may download it by clicking here. The remaining measures are unchanged. The data collection period for these measures is from January 2015 to December 2015.

Visit our Home Health Compare page with drop downs to compare by state, by year, and by release date.  You can also select comparisons for the top 10 percent or top 20 percent.  We also provide a drop down to agency level for Star Ratings.

Home Health Compare Charts Updated – April 2016

The Home Health Compare results were updated April 20, 2016.  Nearly all measures showed improvement.  Four measures remain unchanged while one measure decreased.  The data collection period for these measures is from October 1, 2014 to September 30, 2015.

hhc-star-2016-04

Seven of the nine measures for the Quality of Patient Care Star Ratings showed improvement.  Influenza immunization received for current flu season decreased for the second reporting period in a row and Acute Care Hospitalization remained unchanged.  The nine measures used to calculate the star ratings are identified with an asterisk on Fazzi’s Home Health Compare Charts.  The Quality of Patient Care Star Ratings show 22% of agencies receiving 3 and 3.5 stars.

For HHCAHPS averages, the national score in Specific care issues decreased.  The remaining measures are unchanged. The data collection period for these measures is from October 1, 2014 to September 30, 2015.

Check your Patient Survey Star Ratings.  If your star rating decreased, contact our Gina Mazza, our HHCAHPS Survey Director for improvement tips.

Visit our Home Health Compare page with drop downs to compare by state, by year, and by release date.  You can also select comparisons for the top 10 percent or top 20 percent.  We also provide a drop down to agency level for Star Ratings.

Home Health Medicare Margin

Home Health Margins and Volume Quintile
Quintile 2012 2013 2014 2015
First (Smallest) 7.1 6.1 4.0 7.4
Second 8.1 7.8 5.4 9.6
Third 10.1 8.9 7.6 12.4
Fourth 13.2 11.2 10.0 13.8
Fifth (Largest) 16.8 14.8 12.5 17.6
Sources: MedPAC Report to the Congress: Medicare Payment Policy, March 2014, 2016, and 2017, and MedPAC June 2014 and June 2015 Data Book.
Medicare Margin 2015
All Freestanding HHAs 15.6%
Majority urban 16.0%
Majority rural 13.2%
For profit 16.7%
Nonprofit 12.1%
Freestanding home health agencies had an aggregate margin of 15.6 percent in 2015. MedPAC estimates the marginal profit of HHAs to be 18.1 percent in 2015, higher than the overall Medicare margin.Sources: MedPAC Report to the Congress: Medicare Payment Policy, March 2014, 2016, and 2017 and MedPAC June 2014 and June 2015 Data Book.

Hospice Medicare Margin

Hospice Margins and Volume Quintile
Quintile 2011 2012 2013 2014
First (Smallest) -3.8 -2.3 -0.4 -4.7
Second 2.7 5.8 5.9 2.3
Third 7.6 9.7 9.3 9.6
Fourth 9.3 11.1 10.6 10.0
Fifth (Largest) 9.6 10.5 8.2 8.4
Source: MedPAC Report to the Congress: Medicare Payment Policy. March 2016.

In 2014, the average hospice Medicare margin was 8.2%. Freestanding hospices had higher margins (11.5%), while home health based hospices averaged 3.8% and hospital-based -20.3%.

Source: MedPAC Report to the Congress: Medicare Payment Policy March 2017.