The U.S. Centers for Medicare & Medicaid Services (CMS) announced last month that Home Health Compare — its consumer-facing database of home health provider quality information — will soon be incorporated with seven other Compare sites to create a larger tool named “Medicare Care Compare.”
The goal is to consolidate and make the Compare tool more user-friendly. That’s a goal that hasn’t always been hit in the past, as most Medicare beneficiaries and their families have reported trouble using the online resource from CMS.
“To meet the needs of today’s Medicare beneficiaries and improve the online Medicare customer experience, CMS plans to combine and standardize these eight existing Compare tools, allowing users to access the same information through a single point of entry and simplified navigation to find the information that is currently divided in places like Nursing Home Compare and Hospital Compare,” CMS Administrator Seema Verma said in blog post.
In addition to Home Health Compare, Nursing Home Compare and Hospital Compare, there are also databases for Physician Compare, Hospice Compare, Inpatient Rehabilitation Compare, Dialysis Facility Compare and Long Term Hospital Compare.
So far, providers are largely supportive of the idea of streamlining the Compare portfolio and making things more user-friendly. Many providers agreed that they worried the site had been difficult to utilize, April Anthony, the CEO of Encompass Health’s (NYSE: EHC) home and health and hospice segment, told Home Health Care News.
“We think this is good news, as the current site is difficult for the average consumer to navigate and the data is difficult to find,” Anthony said. “We would be even happier if they would also shorten the lag time in the reported data so that it would be not only easier to find but also a more timely reflection of the current state of affairs relative to an agency’s current quality outcomes.”
If the data is not up-to-date, the Compare tool can be unreliable at giving a glimpse at a company’s most recent track record. Turnover and leadership changes mean some providers can improve and worsen in relatively short periods of time, after all.
Additionally, other home health leaders believe the improvement of the Compare tool can increase its general visibility.
“When the news broke, it didn’t phase me, because I do not feel this change is going to hurt us,” Summer Napier, CEO and founder of Healing Hands Healthcare, told HHCN. “Most people outside of the industry do not realize that Home Health Compare even exists.”
Healing Hands Healthcare is a for-profit in-home care provider that serves 22 counties in north-central Texas. Its offerings range from skilled nursing care and therapy services to medical license social working and private-duty services.
In particular, smaller providers that have worked hard to maintain high ratings and break away from the crowd could benefit, according to Jane Shekman, CEO of LifeCare Home Health & In-Home Services.
LifeCare is a Northbrook-Illinois based company that provides Medicare-certified home health, private-duty nursing and non-medical home care services throughout five Chicago-area counties.
“We are proud of our 5-star rating, and have worked very hard over the last 14 years to maintain this standard,” Shekman said. “It’s hard for the independent home health agencies to compete in an oversaturated Illinois market … It is refreshing to see CMS driving the effort to empower consumers to make their own health care decisions and select providers for their quality care.”
Napier agreed, and also offered up another potential effect that the CMS changes could set off — one that could be advantageous for home-based care providers.
“For the people who do know about the website and visit it for informed decisions, I think this could possibly increase our business and have a positive impact for our organization,” Napier said. “As a 5-star agency — compared to SNFs (skilled nursing facilities) and other agencies — when prospective patients see that they can have the same or better outcomes while remaining in the comfort of their own home, that is the choice they will make.”
Currently, CMS makes it somewhat cumbersome for consumers to compare providers across the eight separate Compare tools on Medicare.gov. The consolidation of those could put SNFs, for instance, and home-based care agencies in more direct competition with each other.
Anthony, however, said consumers will likely still follow doctors’ orders when it comes to post-acute care options and isn’t as bullish on that opportunity.
“That would certainly be a nice by-product,” Anthony said. “I think patients will still be inclined to go where their physician directs them as it relates to choosing home health or SNF-level care. But hopefully within that selected service line they will be better able to choose based on the highest quality.”
The bottom line is that any increase in visibility for smaller organizations that receive high ratings, like LifeCare and Healing Hands Healthcare, is a welcomed change for them. Additionally, patients being able to consider their options with one tool could benefit the home-based care industry as a whole.
“There are so many patients who do not even know that home care is an option and now they will have the opportunity to explore it,” Napier said.
Even with a uniform Compare tool, that introduction to home health care could take time.
“[I think] it will take more time to educate consumers to become more engaged in their self-care or care for their closed ones,” Shekman said. “I do not think that quality indicators would affect a selection of one type of provider over another. For that, the tool would need to provide an apple-to-apple comparison for patient outcomes, which would require more detailed analytical data.”
It puts a lot of pressure on CMS to make sure that the rating system used to compare is meaningful and fair, she also pointed out.
For instance, the characteristics of a patient population — socioeconomic background, amount of chronic conditions, history of hospitalizations — all need to be considered when assessing the providers and their outcome marks.
The consolidated model, “Medicare Care Compare,” is expected to be released sometime this spring. When it is, all home health providers can hope for is a fair system for comparing and more visibility for their services.
“Our hope would be that consumerism will continue to grow in the home health care space,” Anthony said.
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