Providers
How to Compare Home Health Agencies Using Care Compare Scores
Care Compare gives each home health agency two star ratings. They mean different things. See what each score measures. See how to line two agencies up side by side.
Key takeaways
- CMS built Care Compare at Medicare.gov as its official tool. It helps people choose a home health provider.
- Each agency can have two star ratings. One is a Quality of Patient Care rating. The other is a Patient Survey rating. They measure different things.
- The Quality of Patient Care rating is built from care assessments and Medicare claims data. CMS updates it four times a year.
- The Patient Survey rating is built from the Home Health CAHPS survey. That survey asks past patients about their care.
- An agency needs at least 40 completed surveys in the reporting period to get a Patient Survey star rating. A missing survey star is a data gap, not a bad score.
- Stars are a start, not the whole call. Staffing and start dates come from a call to the agency. So does fit for your person's needs.
A hospital discharge planner hands you a list of home health agencies. You get a day to pick one. The list has names and phone numbers. It does not have much else. Care Compare is the Medicare site where the facts sit. It has star ratings and quality scores. It also has survey results from past patients. Used well, it can turn a guess into a fair match.
This guide shows what the two home health star ratings measure. It shows how to line two agencies up. You can do that in our provider directory and on Care Compare. It also shows what only a phone call can settle. It pairs with our home health section. That section covers how Medicare home health itself works.
The two ratings, in plain terms
The Quality of Patient Care Star Rating sums up how an agency's patients do. It uses a set of care measures. CMS builds it from OASIS care assessments. Agency staff fill those out at the start and end of care. CMS also uses Medicare claims. The measures in the rating are:
The Patient Survey Star Rating sums up what past patients said about their care. It is built from four survey measures. They are care of patients and communication between providers and patients. They also cover specific care issues, such as pain and medication talks. The fourth is the overall rating of care. It does not fold in the separate question about whether a patient would recommend the agency. CMS found those answers tracked the overall rating closely.
- Timely Initiation of Care: how often care started on time.
- Improvement in Ambulation: how much better patients got at walking.
- Improvement in Bed Transferring: how much better patients got at moving in and out of bed.
- Improvement in Bathing: how much better patients got at bathing.
- Improvement in Shortness of Breath: how much breathing eased.
- Improvement in Management of Oral Medications: how much better patients got at taking pills the right way.
- Home Health Within Stay Potentially Preventable Hospitalization: how often a hospital stay that might have been prevented took place during care.
How to line two agencies up
Start in the directory. Find each agency's profile. Note its town, its services, and its contact facts. Then open each agency on Care Compare. Work down the same list for both:
Write the two sets of facts side by side on paper. A one-star gap on the measure that matches your case means more. It means more than a tie on the headline star. Our guide on how to compare hospice providers in the directory uses the same method. It uses it for hospice.
- Quality of Patient Care stars: which agency scores higher, and by how much?
- The single measures under that rating: pick the ones that match your case. For a person healing from a hip break, walking and bed transfer scores matter most. For a person with heart failure, the breath score matters most.
- Patient Survey stars: which agency's past patients rated care and communication higher?
- Survey size: an agency with no survey star may be small or new to the survey. Its survey answers are still posted, just without a star.
- Freshness: both ratings update four times a year. A score is a picture of the past year or so, not of this week.
What the scores cannot tell you
Scores are built from past cases. They are grouped and averaged. They cannot tell you who will walk through your door on Tuesday. They cannot tell you if the agency has a nurse free this week. They cannot tell you if its aide team is steady or short-staffed this month. They cannot tell you how staff will get along with your person.
Scores also move slowly. A new manager can change an agency months before the next update shows it. A lost contract can do the same. A small agency can post strong scores on few cases. Then each case counts for more. Treat the scores as a screen. It cuts the list down to two or three names. The call does the rest.
Who pays for home health
The scores on Care Compare cover Medicare-certified agencies. An agency's scores say nothing about what your person's plan will pay. Ask the agency to check coverage for the exact orders. Do that before care starts.
- Original Medicare pays for covered home health services under its own rules. The person and the agency must meet them. Our home health guides cover those rules.
- Medicaid may pay for home health for people who qualify under their state program.
- Private pay covers help that falls outside those rules. That includes extra aide hours a family buys on its own.
Sample situation
Frank is 81 and is going home after hip surgery. His daughter, Lisa, gets a list of four agencies. She opens each one on Care Compare. Two have Quality of Patient Care ratings a full star below the other two, so she sets them aside. Of the two left, Agency A has the higher walking and bed transfer scores, which match Frank's case. Agency B has the higher survey stars for communication.
Lisa calls both. Agency A can start the day after Frank gets home and can send the same nurse for the first two weeks. Agency B cannot start for five days. Lisa picks Agency A: its scores were strongest on the measures that fit her father's case, its survey scores were still solid, and it could start when he needed it. The scores cut her list. The calls made the call. The star marks in this story are a made-up case to show the method. They are not a real agency's rating.
Questions for the call
- When can care start, and who will come for the first visit?
- How often will a nurse visit in the first two weeks, and who sets that plan?
- If I call at night with a worry, who answers?
- How do you tell the family and the doctor how visits are going?
- Which staff will my person see most weeks? Is that team steady?