Are Patient Experience and Outcomes for Home Health Agencies Related?

Abstract

To facilitate home health agency (HHA) selection, CMS released patient experience star ratings on the Home Health Compare website in January 2016. Our objective was to understand the relationship between patient experience and outcomes in HHAs. We utilized publicly reported data to evaluate the relationships among patient experience star ratings, summary quality of care star ratings (comprised primarily of outcome measures), and individual outcome measures for 4,249 HHAs. Results indicate a weak correlation between patient experience and quality stars ( r = .13, p < .001). The difference between the lowest and highest rated HHAs for patient experience is associated with only a half-star improvement in quality stars. The associations between patient experience and individual outcome measures varied, with functional outcomes most strongly associated with patient experience. Findings highlight the importance of reporting separate quality domains; however, conflicting ratings may complicate the HHA selection process and introduce misaligned incentives for HHAs.