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.

Disaster Preparedness for Vulnerable Persons Receiving In-Home, Long-Term Care in South Carolina

2008 ◽  
Vol 23 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Sarah B. Laditka ◽  
James N. Laditka ◽  
Carol B. Cornman ◽  
Courtney B. Davis ◽  
Maggi J. Chandlee
Keyword(s):  
Health Care ◽  
South Carolina ◽  
Home Health Care ◽  
Disaster Planning ◽  
Home Health ◽  
Personal Care ◽  
Term Care ◽  
Care Services ◽  
Health Agencies ◽  
Home Health Agencies

AbstractPurpose:The purpose of this study was to examine how agencies in South Carolina that provide in-home health care and personal care services help older and/or disabled clients to prepare for disasters.The study also examines how agencies safeguard clients' records, train staff, and how they could improve their preparedness.Methods:The relevant research and practice literature was reviewed. Nine public officials responsible for preparedness for in-home health care and personal care services in South Carolina were interviewed. A telephone survey instrument was developed that was based on these interviews and the literature review. Administrators from 16 agencies that provide in-home personal care to 2,147 clients, and five agencies that provide in-home health care to 2,180 clients, were interviewed. Grounded theory analysis identified major themes in the resulting qualitative data; thematic analysis organized the content.Results:Federal regulations require preparedness for agencies providing inhome health care (“home health”). No analogous regulations were found for in-home personal care. The degree of preparedness varied substantially among personal care agencies. Most personal care agencies were categorized as “less” prepared or “moderately” prepared. The findings for agencies in both categories generally suggest lack of preparedness in: (1) identifying clients at high risk and assisting them in planning; (2) providing written materials and/or recommendations; (3) protecting records; (4) educating staff and clients; and (5) coordinating disaster planning and response across agencies. Home health agencies were better prepared than were personal care agencies.However, some home health administrators commented that they were unsure how well their plans would work during a disaster, given a lack of training. The majority of home health agency administrators spoke of a need for better coordination and/or more preparedness training.Conclusions:Agencies providing personal care and home health services would benefit from developing stronger linkages with their local preparedness systems. The findings support incorporating disaster planning in the certification requirements for home health agencies, and developing additional educational resources for administrators and staff of personal care agencies and their clients.

Untapped Potential of Home Health Care Innovations to Improve Outcomes With Bundled Payment Initiatives

2016 ◽  
Vol 29 (1) ◽  
pp. 53-55
Author(s):  
Teresa Lee ◽  
Jennifer Schiller
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Home Health ◽  
Bundled Payment ◽  
Home Based ◽  
Medicare Program ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Home Based Care ◽  
Payment Models

A rapidly changing health care payment system creates opportunities for optimizing home health and home-based care for patients needing cardiac rehabilitation (CR). Home health agencies are poised to play a significant role in episode payment models in the context of post–acute care for patients with cardiovascular conditions. As the Medicare program expands its episode payment models to include patients with cardiovascular conditions, hospitals and other health care stakeholders that will be engaged in these bundled payment arrangements should consider use of home health care in the delivery of CR as a bridge to outpatient therapy and patient self-management.

Association Between the Rate of Diabetes and Quality of Patient Care in Home Health Agencies

2018 ◽  
Vol 31 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Dimitrios Zikos ◽  
Yetunde Ogunneye ◽  
Nailya Delellis ◽  
Lana Ivanitskaya
Keyword(s):  
Home Health Care ◽  
Healthcare Providers ◽  
Primary Diagnosis ◽  
Home Health ◽  
Diabetic Patients ◽  
Health Agencies ◽  
Patients With Diabetes ◽  
Negative Effect ◽  
Information Set ◽  
Home Health Agencies

The multitude of comorbidities and disabilities that are prevalent among diabetic patients make their care very challenging for providers. This, in turn, may have a negative effect on measures of patient satisfaction, quality, and outcomes. This study examines the correlation between diabetes ratio as a primary diagnosis in home health agencies (HHAs) with the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey and the Outcome and Assessment Information Set (OASIS) star ratings. Our result indicates that HHAs with a higher proportion of patients with diabetes have lower ratings in health outcomes (bathing, breathing, moving from the bed, moving around, and controlling pain). The association was stronger in the case of diabetic cases with complications.

Strategies for Implementing the National Standards for Culturally and Linguistically Appropriate Services in Home Health Care

2017 ◽  
Vol 29 (3) ◽  
pp. 168-175 ◽  
Author(s):  
Mary Curry Narayan
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Healthcare Providers ◽  
Home Health ◽  
National Standards ◽  
Sixth Edition ◽  
Health Care Consumer ◽  
Equitable Outcomes ◽  
Consumer Assessment ◽  
Linguistically Appropriate

This article is an abridged version of a book chapter, Culturally and Linguistically Appropriate Services, published in the Handbook of Home Health Care Administration, Sixth Edition (Marilyn Harris, editor). The article describes the importance of culturally and linguistically competent care for the success of home health agencies. It uses the 15 standards of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards) as an outline for identifying strategies that home health leaders can incorporate into their agencies’ practices to enhance their care to culturally and linguistically diverse patients. Providing services that produce equitable outcomes for diverse patients is likely to enhance agency Home Health Compare and HHCAHPS (Home Health Care Consumer Assessment of Healthcare Providers and Systems) scores, Star Ratings, and reimbursement in a value-based reimbursement model.

scholarly journals “You get three different hats on and try to figure it out:” home based care provision during a disaster

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sue Anne Bell ◽  
Sarah Dickey ◽  
Marie-Anne Rosemberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Groups ◽  
Home Health ◽  
Care Provision ◽  
Care Providers ◽  
Home Based ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Home Based Care

Abstract Background Home based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home based care remains a vital source of support for older adults. The purpose of this paper is to qualitatively understand the barriers and facilitators of both patients and providers that influence the provision of home based care activities in two hurricane affected communities. Methods Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home based care providers (n = 25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65 % were registered nurses, 20 % were Licensed Vocational Nurses (LVN), and 15 % were other types of health care providers. 12 % of the sample was male and 88 % was female. Five themes were identified in the analysis: barriers to implementing preparedness plans, adaptability of home based care providers, disasters exacerbate inequalities, perceived unreliability of government and corporations, and the balance between caring for self and family and caring for patients. Conclusions This study provides qualitative evidence on the factors that influence home based care provision in disaster-affected communities, including the barriers and facilitators faced by both patients and providers in preparing for, responding to and recovering from a disaster. While home based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and holistic models of care in the immediate period after the disaster were emphasized. We recommend greater inclusion of home health agencies in the community planning process. This study informs the growing body of evidence on the value of home based care in promoting safety and well-being for older adults during a disaster.

scholarly journals Quantifying Supply of Home Health Services for Public Health Emergencies

2016 ◽  
Vol 29 (1) ◽  
pp. 20-34 ◽  
Author(s):  
Ashlea Bennett Milburn ◽  
Charleen McNeill
Keyword(s):  
Public Health ◽  
Home Health Care ◽  
Health Sector ◽  
Home Health ◽  
Public Health Emergency ◽  
Operating Conditions ◽  
Emergency Rooms ◽  
Surge Capacity ◽  
Health Agencies ◽  
Home Health Agencies

The number of persons seeking medical treatment during a public health emergency could quickly overwhelm the capacity of hospitals and emergency rooms. The amount of surge capacity home health care could provide during a public health emergency is unknown. The purpose of this research is to quantify the surge capacity of the home health sector in four emergency scenarios. According to the model developed, routine demand will exceed scenario capacity for almost all home health agencies in all pessimistic cases for the four scenarios discussed. However, home health agencies have the surge capacity to contribute to the provision of care for patients during times of demand under routine operating conditions as well as in conditions where demand may be moderately increased.

scholarly journals Are Urban Home Health Agencies More Likely to Achieve Improvement in Care Quality?: A Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 247-248
Author(s):  
Chenjuan Ma
Keyword(s):  
Cohort Study ◽  
Home Health Care ◽  
Home Health ◽  
Care Quality ◽  
Timely Initiation ◽  
Hospitalization Rates ◽  
Health Agencies ◽  
Home Health Agencies ◽  
The Mean ◽  
Over Time

Abstract Home health care (HHC) is a core source of home- and community-based services to older adults “aging in place.’ HHC quality is under increasing scrutiny. This study aimed to examine urban vs. rural disparities in HHC quality in the US. This is a cohort study using 2014-2019 national Home Health Compare data linked to Providers of Services (POS) files. Quality of HHC was measured by agency rates of 1) timely initiation of care and 2) hospitalization. We examined 6,448 home health agencies or 38,688 agency-years. At baseline, the mean rate of timely initiation of care was 91.3% (SD: 7.6; range: 28.0-100.0), with urban agencies performing worse (urban vs. rural: 91.0% vs. 92.3%); and the mean rate of hospitalization was 15.6% (SD: 3.7; range: 0.0-37.0), with urban agencies performing better (urban vs. rural: 15.3% vs. 16.4%). Estimates from multivariate hierarchical linear regressions showed that while the rates of timely initiation of care increased annually over time (β= 0.62, p=0.000), this improvement trends did not differentiate between urban and rural agencies (urban: β= 0.087, p=0.086). There was slight annual improvement in hospitalization rates over time (β= -0.07, p=0.0.003) and the trends in annual reduction in hospitalization rates were more significant in rural agencies than urban agencies (urban: β= 0.10, p=0.000). Our findings indicate urban (vs. rural) disparities in HHC quality and the trends of quality improvement.

scholarly journals Home Health Agencies With More Socially Vulnerable Patients Have Poorer Experience of Care Ratings

2021 ◽  
pp. 073346482110538
Author(s):  
Jinjiao Wang ◽  
Meiling Ying ◽  
Yue Li
Keyword(s):  
Ethnic Minorities ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Home Health ◽  
Experience Of Care ◽  
Health Agencies ◽  
Dual Eligible ◽  
Home Health Agencies ◽  
Specific Care ◽  
Racial Ethnic

Objectives Examine the relationships between dual eligibility and race/ethnicity characteristics of Medicare-Certified Home Health Agencies (CHHAs) and experience of care ratings. Methods Analysis of 2017 national Consumer Assessment of Healthcare Providers and Systems and matched datasets of 10,906 CHHAs Results CHHAs with higher concentrations of dual-eligible patients were less likely to have high experience of care ratings for all three domains (e.g., for care delivery, quartile 4 vs. 1: odds ratio [OR] = 0.622, p < .001); CHHAs with higher concentrations of racial/ethnic minorities generally were less likely to have high experience of care ratings in care delivery (e.g., Black: quartile 4 vs. 1: OR = 0.418, p<0.001), communication (e.g., Black: quartile 4 vs. 1: OR = 0.316, p<0.001), and specific care issues (e.g., Hispanic: quartile 4 vs. 1: OR = 0.397, p < .001). Discussion CHHAs with greater concentrations of dual-eligible patients and racial/ethnic minorities were more likely to have poor experience of care ratings.

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 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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