NJ Home-Health Agencies Rank High in First-Time Federal Ratings

Andrew Kitchenman | July 27, 2015 | Health Care
While consumers get valuable help in making healthcare choices, industry representatives say other criteria should be taken into account

Zoom in and move the map to find agencies that overlap on the map. The map shows only New Jersey-based agencies. To see agencies in neighboring states that may provides services to New Jerseyans, see the Medicare.gov website.

New Jersey home-health agencies score well compared with those in other states, but there is plenty of room to improve, according to newly released federal ratings.

New Jersey ranks fifth in the country in the number of agencies that have four or five stars, according to the Centers for Medicare and Medicaid Services (CMS), which recently released home-health ratings for the first time.

In addition, only one of 46 New Jersey agencies rated had fewer than three stars, the lowest percentage of subpar performers of any state.

Federal officials said the Home Health Compare ratings allow consumers to quickly identify differences in quality as they make healthcare decisions, while also helping agencies identify areas to improve.

Industry representatives met the ratings with a cautious response, noting that the health outcomes of residents, which form the basis for the ratings, can vary based on the health status of the people served by the agencies.

Of 46 New Jersey agencies that were rated, 18 had at least four stars, equal to 39 percent of all Garden State agencies. Only Rhode Island, Utah, Florida, and California had a higher share of agencies with high ratings, according to data compiled by Kaiser Health News. These top-rated agencies were spread fairly evenly across the state, including facilities in 15 different counties.

Two New Jersey agencies weren’t rated because there wasn’t enough information, while 14 others that serve parts of New Jersey are based in other states.

The different measures that go into calculating these ratings are becoming increasingly important as the federal government seeks to base more healthcare payments on how well providers perform, rather than just on the amount of services they perform.

Home-health agencies are the sixth category of healthcare groups that has received “star” ratings, following ratings for nursing homes, doctors, dialysis facilities, Medicare Advantage plans, and hospitals.

Chrissy Buteas, president and CEO of the New Jersey Home Care and Hospice Association of New Jersey, said New Jersey agencies’ commitment to quality was “demonstrated” by the ratings. But she noted that while the ratings are “one of many tools” that patients can use, there are limits to their usefulness.

“The star ratings alone may not appropriately reflect the quality of a home-health agency that did not appear to fare as well,” she said in a statement, noting that some agencies treat patients who are sicker than those at other agencies.

Only one New Jersey agency received as few as two and a half stars – Mount Laurel-based Virtua Home Care-Community Nursing Services. However, a separate Virtua agency, Virtua Home Care at West Jersey, received three and a half stars.

In addition, three out-of-state agencies that serve parts of New Jersey had two and a half stars: Epic Health Services of Bala Cynwyd, PA; Superior Health Services of Dupont, PA; and Wartburg Home Care of New Rochelle, NY.

Buteas said people should consult with their doctors and check several different sources in choosing a home-health agency.

“Consumers should be aware that an agency that receives what may be interpreted as an average rating is actually an agency that provides quality care,” Buteas said.

CMS compiled two different sets of scores for each agency – the first based tatistics that each agency reports on how they treat patients and how patients’ health improves, and the second based on data from a survey of patients.

The overall rating is based on nine measures. The first three are how often an agency initiated patient care in a timely manner, provided patient and caregiver drug education about all medications, and provided patients received flu vaccines for the current season.

The other measures used in the ratings were based on included how often patients got better at walking or moving around, getting in and out of bed, and bathing themselves. In addition, they included how often patients engaged in activity with less pain, experienced less shortness of breath, and required acute care hospitalization.

Buteas said CMS should provide more information to consumers “to educate them about how to use the ratings and what they mean in terms of quality.” She added that CMS should better account for the health of patients, “which may influence an agency’s quality score but is out of the (home health) agency’s control.”

Some agencies with good ratings were quick to point to them as a positive sign. For example, the Visiting Nurse Association Health Group noted that VNA of Central Jersey and all three of its joint ventures – Cape VNA, Robert Wood Johnson Visiting Nurses, and VNA of Englewood – received at least four stars.

The range of services provided by home-health agencies includes nursing care, physical therapy, occupational therapy (rehabilitation in performing daily tasks), speech therapy, medical social services, and home health aides.

“Receiving these kinds of results comes from dedicated clinical teams who work hard to deliver the highest quality of home health care to our more than 120,000 patients each year,” VNA Health Group President and CEO Dr. Steve Landers said.

CMS officials said the ratings are part of a broader effort to transform how healthcare is delivered.

“Adding star ratings to Home Health Compare is another step forward in our continuing efforts to empower consumers by providing more information to help them make health care decisions, while also encouraging providers to strive for higher levels of quality,” said Dr. Patrick Conway, CMS’s acting principal deputy and deputy administrator for innovation and quality.