Home Health CAHPS FAQs: Understanding the CAHPS Rating
By Alyssa Ciancibello | 08/16/2021
CAHPS Star Ratings are a summary of health care provider performance measures.
Understanding the CAHPS Star Rating System
If you’re involved in the Home Health industry, you’re probably familiar with Home Health CAHPS patient surveys. These quarterly-reported patient surveys have been required by the Centers for Medicare and Medicaid Services (CMS) since 2010.
In 2016, CMS added the Star Rating System to the information presented on the Home Health Compare website. This visual element is designed to make it easier for consumers to compare providers, but the methodology behind the Star Ratings can be a little difficult to understand. To help clarify, we’ve developed a list of Frequently Asked Questions to provide answers to some of our most common inquiries.
What is the goal of CAHPS ratings?
The Consumer Assessment of Healthcare Providers and Systems Home Health Care Survey (HHCAHPS) is designed to measure the experiences of people receiving home health care from Medicare-certified home health care agencies. The survey was created to meet the following three broad goals:
- To produce comparable data on the patient’s perspective that allows objective and meaningful comparisons between home health agencies on areas that are important to consumers.
- To publicly report survey results as an incentive for agencies to improve their quality of care.
- To enhance public accountability through publicly reporting in health care by increasing the transparency of the quality of care provided in return for public investment.
What are CAHPS Star Ratings?
Star Ratings are a summary of health care provider performance measures. Comparing star ratings across home health agencies is designed to make it easier for consumers to make quality, informed decisions on home health care services.
The results from the Patient Survey are reported under the Patient Survey Star Ratings on the CMS website.
Why is there more than one star rating on Home Health Compare?
In January 2016, the Patient Survey Star Rating (also known as the Home Health CAHPS Star Rating was added to Home Health Compare. The HHCAHPS Star Ratings uses feedback from surveys of home health patients and caregivers.
The Quality of Patient Care Star Ratings are also offered to be used together with the HHCAHPS Star Ratings to provide a more comprehensive view of the quality of care provided by a home health agency. The Quality of Care star rating is a calculation based upon completely separate criteria, including the Outcome and Assessment Information Set (OASIS) and Medicare claims data. Information on this rating can be found on the CMS website.
Who can participate in HHCAHPS surveys?
Eligible Home Health Agencies have the potential to receive a star rating. To be eligible, Home Health Agencies must have 40 or more completed surveys over the four-quarter reporting period to receive Star Ratings for that reporting period. Home health agencies that do not have 40 or more completed surveys for calculating Star Ratings will still have their HHCAHPS data publicly reported on the Home Health Compare website, but they will not receive star ratings.
HHCAHPS scores based on fewer than 40 completed surveys do not have sufficient statistical reliability to ensure that those scores measure true performance.
How are the star ratings compiled?
Star Ratings are applied to each of the three publicly reported composite measures, which are drawn from specific questions on the HHCAHPS Survey.
The three HHCAHPS composite measures are:
- Care of Patients
- Communication Between Providers and Patients
- Specific Care Issues
In addition, a Star Rating will be applied to the HHCAHPS global item:
- Overall Rating of Care Provided by the Home Health Agency (Q20)
The star rating does not include responses to the “Would patients recommend the home health agency to friends and family” item because the results for this item are very similar to those based on the Overall Rating of Care.
What if there are errors in the report?
Each Home Health Agency provider will receive a preview of their Public Report with their Star Rating approximately three months before the ratings are posted publicly on Care Compare. Agencies have several weeks to review and dispute any errors in their rating.