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Quality of patient care star ratings

 

What do the quality of patient care star ratings measure?

 

The quality of patient care star rating is a summary measure of agency performance based on how well a home health agency performs on 8 of the individual quality measures reported on Home Health Compare. These 8 measures include:

Process of care measures – how often the agency:

 

  1. Initiated patient care in a timely manner

 

Outcome of care measures – how often the patient:

 

  1. Got better at taking their drugs correctly by mouth
  2. Got better at walking or moving around
  3. Got better at getting in and out of bed
  4. Got better at bathing themselves
  5. Experienced less shortness of breath
  6. Required acute care hospitalization

 

These measures were selected to give a general overview of agency performance on measures that apply to the most people. Learn more about these individual quality measures.

 

Where do the quality of patient care star ratings come from?

 

The quality of patient care star ratings are calculated using each home health agency’s scores on 8 individual quality measures, which are based on home health agency patient assessments and Medicare claims. Get information about the time period on which the current star ratings are based.

 

Which home health agencies get quality of patient care star ratings?

 

Currently, home health agencies must have at least 20 complete quality episodes for data on a measure to be reported on Home Health Compare. (Completed episodes are paired start or resumption of care and end of care OASIS assessments.) Episodes must have a discharge date within the 12-month reporting period regardless of admission date. To have a quality of patient care star rating computed, home health agencies must have reported data for 5 of the 8 measures used in the star rating calculation.

Get the detailed methodology for calculating the quality of patient care star ratings- Opens in a new window.

 

How often are the quality of patient care star ratings updated?

 

The quality of patient care star ratings are updated quarterly, at the same time the data on the individual quality measures are updated. This means the quality of patient care star rating for each home health agency may change from one quarter to the next.

How Do I Get Part A and Part B?

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Understanding Medicare Advantage Plans

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Understanding Medigap or Medicare Supplement Plans

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If you are not a LIS client (Low Income Subsidy or on Medicaid or shared cost subsidies) then you are restricted to a five (5) star rated plan.

 

CMS released its report card for Medicare Advantage and Part D prescription drug plans Oct. 10, 2020.

 

Medicare ranks Medicare Advantage and Part D plans on a quality scale of one to five stars, with five representing excellent performance and one reflecting poor performance. CMS also pays bonuses to plans with high ratings.

 

In 2020, most beneficiaries will be able to select a Medicare Advantage or Part D plan with four or more stars, CMS said. To assign stars, Medicare analyzes how health plans performed on 45 measures for Medicare Advantage and Part D plans; 33 measures for only Medicare Advantage plans; and 14 measures for standalone Part D prescription drug plans.

 

Here are the plans receiving a five-star rating:

 

 

Medicare Advantage and Part D

 

Kelsey-Seybold Administrators in Texas
Kaiser Foundation Health Plan in California
Kaiser Foundation Health Plan of Colorado 
Humana's CarePlus Health Plans in Florida
Guidewell's Florida Blue Medicare
Kaiser Foundation Health Plan of Georgia
Kaiser Foundation Health Plan in Hawaii 
Martin's Point Generations Advantage in Maine and New Hampshire
UnitedHealth Group's Care Improvement Plus South Central Insurance Co. in New York
Kaiser Foundation Health Plan of The Mid-Atlantic States
Kaiser Foundation Health Plan of the Mid-Atlantic States (different contract)
Tufts Associated Health Maintenance Organization in Massachusetts 
HealthPartners' Group Health Plan in Minnesota, Wisconsin, South Dakota and North Dakota
CVS Health's Aetna Health in Maine
UnitedHealthcare Benefits of Texas
Kaiser Foundation Health Plan of Washington 
Madison-based University of Wisconsin Hospitals and Clinics' Quartz Health Plan Corp.
Cigna's HealthSpring of Florida
Anthem's Healthsun Health Plans in Florida

Quartz Health Plan Minnesota Corp.

 

Medicare Advantage only

 

Medical Associates Health Plan in Iowa, Illinois and Nebraska


Part D only 

 

Anthem Insurance Co. & Blue Cross Blue Shield of Massachusetts, Rhode Island and Vermont
Lifetime HealthCare's Excellus Health Plan

 

 

 

 

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