Case managers simply are not aware that an unbiased resource exists for helping hospitalized patients select a home health agency, a new study finds.

Although case managers often use a Medicare website that helps patients select a long-term care facility, a similar site with home healthcare comparisons has not been on their radar, says Rosa Baier, MPH, associate director of the Center for Long-Term Care Quality and Innovation at Brown University in Providence, RI.

Baier and co-researchers intended to investigate the attributes and shortcomings of the Medicare Home Health Compare website (www.medicare.gov/homehealthcompare/search.html) and were surprised to learn that case managers and consumers were unaware of the resource.

The study also found that case managers felt there was little difference in home health agency quality.1

“It was an interesting finding,” Baier says. “We were going to ask them what they thought of the home health agency reports and what they would do differently, but nobody was aware of them or had used them.”

However, case managers are aware of the Centers for Medicare & Medicaid Services’ (CMS) Nursing Home Compare website, she notes.

“Most case managers use Nursing Home Compare regularly, but they are not aware of Home Health Compare,” Baier says.

The findings suggest that case managers need to learn more about available state and Medicare public reports. These are particularly helpful when patients ask for their advice about which home health agency to select.1

“Case managers are charged with informing consumers and directing the consumer decision-making process without infringing on patients’ freedom of choice,” Baier says. “Having access to Home Health Compare gives them an unbiased resource to compare agencies without breaking federal consumer laws.”

Also, case managers might educate themselves about the home health agencies available in their areas. “When we spoke with hospital case managers, we found they were aware that although they felt home health was comparable across the board, they didn’t have a feedback loop to know what happened to patients after discharge and whether their home health decision was a good one,” Baier says.

“Home Health Compare can provide patient satisfaction information with knowledge captured that case managers really don’t have,” she adds.

The Home Health Compare site is an easy-to-navigate resource that patients or case managers can use to find out about home health agencies’ patient satisfaction rates. It was updated in January 2015. For example, they can put in the patient’s ZIP code and find agencies that serve their area. A comparison listing has a quick view with checkmarks indicating whether the agency provides any or all of these services: nursing care, physical therapy, occupational therapy, speech therapy, medical social services, and home health aides. When the agency’s name is clicked, the new page provides general information, quality of patient care indicators, and patient survey results.

The quality of patient care indicators compare the agency’s results to the state and national averages, which report results on the following items:

  • how often patients got better at walking or moving around;
  • how often patients got better at getting in and out of bed;
  • how often patients got better at bathing.

The patient survey results cover the following:

  • how often the home health team gave care in a professional way;
  • how well the home health team communicated with patients;
  • whether the home health team discussed medicines, pain, and home safety with patients;
  • how patients rate the overall care from the home health agency;
  • if patients would recommend the home health agency to friends and family.

Reference

  1. Baier RR, Wysocki A, Gravenstein S, et al. A qualitative study of choosing home health care after hospitalization: the unintended consequences of ‘patient choice’ requirements. J Gen Intern Med. 2015;epub ahead of print.