Methodology and Source

CMS Quality Measures


Centers for Medicare & Medicaid Services (CMS) Home Health Compare:

Data for quality measures for Certified Home Health Agencies and Long Term Home Health Care Programs comes from the national Outcome and Assessment Information Set (OASIS) repository.  OASIS is an assessment conducted by CHHA or LTHHCP professional staff at regular intervals for patients receiving Medicaid or Medicare skilled home health services.  

The quality measures show how often each agency used best practices when caring for its patients and whether patients improved in certain important areas of care.  These quality measures or indicators show the performance of an agency compared to other agencies using star ratings.  Agencies get a rating from 1 to 5 stars for each quality indicator, with 1 being the lowest score and 5 representing the highest performance.   Agencies get more stars when they follow recommended care practices for patients, and when more of their patients show improvement.  

Data for quality measures also comes from a patient experience of care survey, the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey.  This survey collects feedback from patients/families about their experience with a certified home health agency.  Agencies get a rating from 1 to 5 stars for each quality indicator, with 1 being the lowest score and 5 representing the highest performance, based on results of the HHCAHPS Survey.     

Data for quality measures is also pulled from Medicare claims (bills) related to re-hospitalization and hospital emergency room visits.  Agencies get a rating from 1 to 5 stars, with 1 being the lowest score and 5 representing a higher score (fewer re-hospitalizations or fewer emergency visits).  

Methodology for Quality Measure Performance Rankings:

For each quality measure, the Certified Home Health Agencies/Long Term Home Health Care Programs in New York State have been divided into five groups according to their scores, with roughly 20 percent of the agencies in each group. The mathematical term for such a group is a "quintile," meaning a fifth (1/5). The group with the highest scores for a quality measure is usually considered the most preferable group--a five-star ranking. The group with the lowest scores is usually considered the least preferable group--a one-star ranking. 

For some quality measures, there are many certified home health agencies/long term home health care programs with identical scores. When assigning these agencies to a ranking group, all agencies with the same score must be assigned the same rank. This results in the five-star group having more than 20 percent of the agencies in it, and one or more of the other groups having fewer than 20 percent of the agencies. This is okay, the normal result of tie scores. The situation is similar to a footrace in which the two front-runners have tied. They both share the #1 spot on the awards platform, but the runner who finished just behind these two runners stands on the #3 spot, because two runners finished ahead of him. 

Please note that the quality measure performance rankings are designed to show how certified home health agencies rank in relation to other certified home health agencies in New York State.