Medicare Watch

Your Weekly Medicare Consumer Advocacy Update

New Star Ratings for Patient Experience with Home Health Care

February 4, 2016

CMS Now Provides Star Ratings for Home Health Care Agencies

People who need or who are receiving home health care can now look up star ratings for home health care agencies using the new Home Health Compare tool from the Centers for Medicare & Medicaid Services (CMS). The new tool is part of a suite of tools to compare other aspects of health care, including hospitals, physicians, nursing homes, Medicare plans, and suppliers.

Just like other compare tools, Home Health Compare rates agencies using the standard scale of one star to five stars, with five being the best rating. Agencies are rated on a variety of areas, including care of patients, communication between providers and patients, specific care issues, and the overall rating of the care provided. The tool contains over 11,000 agencies. To date, about 6,000 agencies have ratings. CMS is still collecting data on the other agencies and will continue to update the tool with new ratings.

According to CMS, “[The] announcement on Home Health Compare is the latest example of how CMS is committed to transparency and helping patients and their family members make informed health care decisions through an initiative to simplify the quality of care information across all CMS Compare websites. It also supports the larger effort across the Department of Health and Human Services (HHS) to build a health care system that delivers better care, spends health care dollars more wisely, and results in healthier people.”

Read about Home Health Compare.

CMS Announces Proposed Improvements to Medicare Shared Savings Program

This week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to update the methodology used to measure the performance of Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program. The proposal seeks to improve the long-term incentives for ACOs to provide efficient, high quality health care to Medicare beneficiaries.

Under the proposed rule, CMS would modify the process for resetting the standards (also known as benchmarks) used to evaluate the performance of ACOs renewing their participation agreements. The proposed methodology would incorporate factors based on regional fee-for-service expenditures, meaning that ACOs will be evaluated against regional, rather than national, spending trends.

These proposals are the product of stakeholder input, including comments submitted on the methodology used to reset ACO benchmarks in a proposed rule released in 2014. Medicare Rights joined the National Partnership for Women & Families, Community Catalyst, National Health Law Program (NHeLP), and other allies on comments submitted by the Campaign for Better Care on the prior proposed rule.

Medicare Rights is reviewing the latest CMS proposal and will comment, as needed, on issues important to Medicare beneficiaries and their families.

Read the proposed rule.

Read the Campaign for Better Care comments on the 2014 proposed rule.

Volume 7, Issue 5

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Medicare Reminder

Medicare may help pay for your certain types of home care if you are considered homebound, meaning that all the following apply:

  • You need the help of another person or special equipment to leave your home or your doctor believes that leaving your home would be harmful to your health; and
  • It is difficult for you to leave your home and you typically cannot do so.
  • You need skilled care. This includes skilled nursing care on an intermittent basis.
  • Your doctor signs a home health certification stating that you qualify for Medicare home care because you are homebound and need intermittent skilled care. The certification must also say that a plan of care has been made for you, and that a doctor regularly reviews it.
  • You receive your care from a Medicare-certified home health agency (HHA).

See Medicare Interactive for more information and additional details and limitations on when a person qualifies for Medicare-covered home health care, and what types of home health care Medicare may cover.

 

Spotlight

In the most recent issue of the American Society on Aging’s newsletter Aging Today, Stacy Sanders, Federal Policy Director of the Medicare Rights Center, is featured as one of three leading advocates for the aging population.

The article highlights Stacy’s important work advocating for older adults and people with disabilities, detailing her various accomplishments. Looking forward, Stacy also explains what she and the Medicare Rights Center hope to accomplish for people with Medicare through ongoing advocacy campaigns.

Read the Aging Today article.

 

Stay up-to-date on Medicare policy and advocacy developments, and learn about changes in Medicare benefits and rules with this weekly newsletter.

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