How to choose a certified home health provider

Certified home health is a service regulated by the Center for Medicare and Medicaid Services (CMS). Organizations that provide certified home health are referred to as home health agencies or HHAs or CHHAs. I will refer to them as HHAs in this post.

Instructions

Difficulty: Moderately Challenging

Things You’ll Need:

• An Internet connection
• The patient's zip code
• Or, the names of the HHAs you wish to evaluate

1. Navigate to the CMS Home Health Compare website. Create a list of potential agencies. Choose the list within 20 miles of where the patient lives and select from those who have achieved at or above acceptable quality measures. Note the performance scores have a lag time of nearly 9 months. Some agencies may have improved their scores since the measures were published. Check the CMS website for the date of the last update.
2. Call your local hospital discharge planning department and/or your physician's office to ask if they have a recommendation from your list.
3. Call the HHA directly and ask to speak to a clinical manager. Ask the manager the following questions:
   - Are your quality outcomes the same or better than those published on the CMS website?
   - What is the average number of visits per episode of care that your agency provides to its patients?
   - Do you provide telemonitoring to your patients?
   - Name the patient's primary and secondary diagnosis, ask the agency representative if there are any specialty programs designed to care for patients of these diagnoses
   - Ask the agency what special programs are in place to prevent unplanned rehospitalization or emergency room admissions
   - Ask the agency if their home nursing staff is equipped with an electronic medical record, computerized clinical documentation, and/or evidence based clinical decision support at the point of care (available while the clinician is in the patient's home and providing care)?

Tips & Warnings

• Quality measures are the best indicator of the effectiveness of the clinical care provided by a home health agency
• Quality is improved through use of technologies such as computerized clinical documentation, electronic medical records, Internet access for clinical decision support, etc.
• The number of visits per episode of care averages between 15-17 per 60 days
• Use of an electronic medical record reduces medical errors