Patient experience and process measures of quality of care at home health agencies: Factors associated with high performance

2017 ◽  
Vol 36 (1) ◽  
pp. 29-45 ◽  
Author(s):  
Laura M. Smith ◽  
Wayne L. Anderson ◽  
Lisa M. Lines ◽  
Cristalle Pronier ◽  
Vanessa Thornburg ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Patient Experience ◽  
High Performance ◽  
Home Health ◽  
Process Measures ◽  
Factors Associated ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Care At Home

scholarly journals PATTERNS OF PERFORMANCE ON QUALITY OF CARE AMONG U.S. HOME HEALTH AGENCIES, 2015-2017

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S494-S494
Author(s):  
Chenjuan Ma
Keyword(s):  
Quality Of Care ◽  
Home Health ◽  
Community Dwelling ◽  
Home Healthcare ◽  
Healthcare Sector ◽  
Star Rating ◽  
Health Agencies ◽  
The Us ◽  
Home Health Agencies

Abstract Home healthcare is a critical care source for community-dwelling older adults. As the fastest growing healthcare sector in the US, quality of home healthcare is under increasing scrutiny. The purpose of this study is to examine patterns of performance on quality of care among US home health agencies. This is a 3-year cohort study using 2015-2017 Home Health Compare data and Provider of Services (POS) Files. In the dataset, each HHA was assigned a star rating (1-5) to reflect the overall quality of care. This indicator was calculated based on two process measures (timely initiation of care and drug education) and six outcome measures (e.g., hospitalization). We examined 8,020 HHAs in the US. Over the 3-year period, the number of HHAs receiving a star rating of 4 or 5 increased from 27% in 2015, 31% in 2016, to 32% in 2017. Roughly, 32% of the HHAs received a lower star rating and another 32% received a higher star rating from 2015 to 2016. Similarly, 30% of the HHAs received a lower star rating and 29% of the HHAs received a higher star rating from 2016 to 2017. Hospital-based HHAs were less likely to receive a star rating of 4 or 5. Larger HHAs (OR 1.34; 95% CI, 1.13-1.59) and HHAs with ownership changes (OR, 1.38; 95% CI 1.20-1.59) were more likely to improve their star ratings overtime. Our finding indicates dynamic changes in the quality of care within the US home healthcare sector.

Early Effects of Home Health Value-Based Purchasing on Quality Star Ratings

2020 ◽  
pp. 107755872095229
Author(s):  
Salom M. Teshale ◽  
Margot L. Schwartz ◽  
Kali S. Thomas ◽  
Tracy M. Mroz
Keyword(s):  
Patient Care ◽  
Patient Experience ◽  
Quality Measures ◽  
Home Health ◽  
Value Based Purchasing ◽  
Health Value ◽  
Quality Of Patient Care ◽  
Health Agencies ◽  
Home Health Agencies

The Home Health Value-Based Purchasing Model (HHVBP) is a new Medicare model wherein home health agencies compete to achieve higher reimbursements by demonstrating improved value according to clinical and patient experience-related quality measures. Many measures used in HHVBP overlap with measures used in quality star ratings for home health agencies. Thus, improvements in quality measures used in HHVBP may also be reflected in changes in star ratings. However, it is unclear whether agencies competing in HHVBP improve their Centers for Medicare & Medicaid Services star ratings compared with those not competing. Using publicly available data from Centers for Medicare & Medicaid Services, we evaluated the effect of HHVBP on quality of patient care and patient experience composite star ratings over a 2-year period using a difference-in-differences analysis. We found evidence for a small, statistically significant increase in quality of patient care star ratings for agencies participating in HHVBP, and no effect on patient experience ratings.

scholarly journals Patient-Rated Performance of Home Health Agencies and Hospitalization Risk: A Propensity-Score Matched Analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 536-536
Author(s):  
Chenjuan Ma ◽  
Lisa Groom ◽  
Shih-Yin Lin ◽  
Daniel David ◽  
Abraham Brody
Keyword(s):  
Health Care ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Patient Experience ◽  
Home Health Care ◽  
Healthcare Providers ◽  
Home Health ◽  
High Performing ◽  
Health Agencies ◽  
Home Health Agencies

Abstract Home health care is the most commonly used home- and community-based service to older adults “Aging in Place”. Patient experience of healthcare services is a critical aspect of patient-centered care. Indeed, policymakers have linked patient-rated quality of care to payment to healthcare providers. This study aimed to examine the association between patient-rated care performance of home health agencies and risk for hospitalization among Medicare beneficiaries. This study used several national datasets from 2016 and included 491,718 individuals from 8,459 home health agencies. Home health agencies’ performance was measured using patient experience star rating from the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS). Propensity score matching was used to balance the differences in patient characteristics at baseline between those receiving care from high-performing home health agencies and those in lower-performing agencies. On average, patients were 80.5 years old, 65% female, 81% White, 10% Black, and 6% Hispanic, with 90% taking 5 or more medications. Patients had a mean score of 1.73 (SD=1.69) on the Charlson Index. Respectively, 10% and 16% of patients were hospitalized within 30 and 60 days of home health care initiation. Estimates of logistic regression after propensity score matching found that patients receiving care from lower-performing agencies were at similar risk for both 30-day (OR=0.99, p=0.817) and 60-day (OR=1.02, p=0.616) hospitalization following the start of home health care, compared to those in high-performing agencies. Our findings suggest discrepancies (or no relationship) between patient experience and objective outcomes of home health care.

The Hospice Movement: Institutionalizing Innovation

1986 ◽  
Vol 16 (1) ◽  
pp. 71-85 ◽  
Author(s):  
Emily K. Abel
Keyword(s):  
Home Health ◽  
Critical Force ◽  
Personal Relationships ◽  
Hospice Movement ◽  
Health Agencies ◽  
Medicare Benefit ◽  
Home Health Agencies ◽  
The Government ◽  
The 1960S

The early leaders of the hospice movement shared a number of attitudes with the founders of the alternative institutions of the 1960s and early 1970s: nostalgia for simple, old fashioned ways, dissatisfaction with bureaucratic and authoritarian institutions, faith in the power of nature, a determination to avoid domination by experts, and a desire to improve the quality of personal relationships. However, as hospices have become better established, they gradually have been incorporated into the dominant health care system and have lost their uniqueness. Some have affiliated with hospitals or home health agencies. Even autonomous organizations are subject to pressures for accommodation because they rely on the established order for resources, personnel, and political acceptance. Organizations receiving payment under the new Medicare benefit must adhere to a set of regulations that may distort the movement. Though creation of this benefit may have been facilitated by increased support for hospice ideals, the government views hospices primarily as a way to save money. Paradoxically, as hospices have grown in popularity, the critical force of the movement has been blunted.

scholarly journals The Relationships Between Patient Experience and Quality and Utilization of Primary Care Services

2020 ◽  
Vol 7 (6) ◽  
pp. 1678-1684
Author(s):  
Jaya Aysola ◽  
Chang Xu ◽  
Hairong Huo ◽  
Rachel M Werner
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Patient Experience ◽  
Smoking Status ◽  
Care Quality ◽  
Cross Sectional ◽  
Process Measures ◽  
Care Services ◽  
Patient Reported

We lack knowledge on how patient-reported experience relates to both quality of care services and visit attendance in the primary care setting. Therefore, in a cross-sectional analysis of 8355 primary care patients from 22 primary care practices, we examined the associations between visit-triggered patient-reported experience measures and both (1) quality of care measures and (2) number of missed primary care appointment (no shows). Our independent variables included both overall patient experience and its subdomains. Our outcomes included the following measures: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status (nonsmoker vs smoker), diabetes control Hemoglobin A1c (HbA1c [<8]), blood pressure control, cholesterol control Low Density Lipoprotein (LDL) among patients with diabetes (LDL < 100), and visit no shows 2 and 5 years after the index visit that triggered the completed patient-experience survey. We found that patient experience, while an important stand-alone metric of care quality, may not relate to clinical outcomes or process measures in the outpatient setting. However, patient-reported experiences with their primary care provider appear to influence their future visit attendance.

Evaluating the Quality of Home Care in China Using the Home Care Quality Assessment Tool

2020 ◽  
pp. 104365962095319
Author(s):  
Xianping Tang ◽  
Song Ge ◽  
Chenjuan Ma ◽  
Xuemei Chen ◽  
Yaolin Pei ◽  
...  
Keyword(s):  
Home Care ◽  
Rural Areas ◽  
Assessment Tool ◽  
Home Health ◽  
Care Quality ◽  
Quality Assessment Tool ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Quality Of Home Care

Introduction This study aimed to evaluate the quality of home care in China using the Home Care Quality Assessment Tool (HCQuAT). Method We recruited 38 home health agencies in Shanghai, China, which included 18 in urban areas, 11 in suburban areas, and nine in rural areas. Data on quality of home care from each agency were collected by trained staff using the HCQuAT. Results On average, these home health agencies scored 74.28/100.00 ( SD = 6.80) on the HCQuAT, with an excellence rate of 39.5% and a failing rate of 23.7%. The mean scores on the structure quality module, process quality module, and outcome quality module were 71.2 ± 21.8, 86.6 ± 9.2, and 44.1 ± 37.5, respectively. Significant differences existed across geographic locations ( p = .018). Discussion Significant variations were identified in the quality of home care across quality modules and geographic locations. Outcome quality and quality in rural areas were lower than those for their counterparts.

scholarly journals Quality of Home Health Agencies Serving Traditional Medicare vs Medicare Advantage Beneficiaries

2019 ◽  
Vol 2 (9) ◽  
pp. e1910622 ◽  
Author(s):  
Margot L. Schwartz ◽  
Cyrus M. Kosar ◽  
Tracy M. Mroz ◽  
Amit Kumar ◽  
Momotazur Rahman
Keyword(s):  
Home Health ◽  
Medicare Advantage ◽  
Health Agencies ◽  
Home Health Agencies

scholarly journals Identifying Associations between Quality Initiatives and Quality Measures among Home Health Agencies: Findings from a National Study

2021 ◽  
Vol 14 ◽  
pp. 117863292199209
Author(s):  
Jacqueline S Zinn ◽  
Heather Ladd ◽  
Eugene Nuccio ◽  
Susan L Ettner ◽  
Dara H Sorkin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Support Groups ◽  
Patient Experience ◽  
Quality Measures ◽  
Home Health ◽  
National Study ◽  
Quality Initiatives ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Improved Performance

Home health performance gained visibility with the publication of Home Health Compare and the Home Health Value-Based Payment demonstration. Both provide incentives for home health agencies (HHA) to invest in quality improvements. The objective of this study is to identify the association between quality initiatives adopted by HHAs and improved performance. A 2018 national survey of 7459 HHAs, yielding a sample of 1192 eligible HHAs, provided information about 23 quality initiatives, which was linked to 5 composite Super Quality Measures (SQMs): ADL/pain, self-treatment, timely care, hospitalizations, and patient experience. Exclusions for missing data and outliers yielded a final analytical sample of 903 HHAs. Regression models estimated associations between quality initiatives and SQMs. The relationships between sixteen of the SQM/quality initiative pairs were positively associated with improvement and 7 were negatively associated. Web-based technologies for staff and care-givers improved performance but deteriorated patient experience. Web support-groups for staff and review of HHC rankings reduced hospitalization rates. While this study offers insights for quality improvement, a limitation may be a lack of sensitivity to the nuances of quality improvement implementation. Therefore, this study should be viewed as hypothesis-generating concerning initiatives likely to have the greatest potential meriting further investigation.

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