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Study Finds Introduction of Quality of Care, Patient Experience Stars Associated with Changes in HHA Selection

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A new study compared the impact of the introduction of two distinct sets of star ratings, quality of care, and patient experience, on home health agency (HHA) selection.  The study, published in Health Services Research, found the introduction of quality of care and patient experience stars were associated with changes in HHA selection.

The study used 2014-2016 home health Outcome and Assessment Information Set (OASIS) assessments, as well as publicly reported data from the Home Health Compare website.  The study analyzed 186,498 admissions for new Medicare Fee-for-Service home health users.  This admission-level assessment compared HHA selection before (July 2014-June 2015) and after (February-December 2016) star ratings were published.

The study found that the introduction of star ratings was associated with a 0.88-percentage-point increase in the probability of selecting a high-quality HHA and a 0.81-percentage-point increase in the probability of selecting a highly ranked patient experience HHA. Patients admitted from the community, and black and Medicare-Medicaid dual-eligible beneficiaries experienced larger increases in their likelihood of selecting high-rated agencies than inpatient, white, and nondual beneficiaries.

The introduction of quality of care and patient experience stars were associated with changes in HHA selection; however, the strength of these relationships was weaker than observed in other health care settings where a single star rating was reported. The introduction of star ratings may mitigate disparities in HHA selection. These findings highlight the importance of reporting information about quality and satisfaction separately and conducting research to understand the mechanisms driving HHA selection.

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