What Home Healthcare Owners Need To Know About Medicare Star Ratings
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What Home Healthcare Owners Need To Know About Medicare Star Ratings

What Home Health Owners Need to Know About Medicare Star Ratings

You Care Way Too Much

First off, let's get one thing straight - you probably care too much about Medicare star ratings and your patients probably have no idea what they mean. This may be for good reason - maybe a government mandated rating system is not what consumers want when finding healthcare.

While the industry serves as an Echo Chamber for talking about star ratings, the public seems to know very little. Here is a study from the Journal of General Internal Medicine regarding “Patient Choice” requirements and how they affect decision making. In it, the researchers interviewed 13 consumers and 28 care managers regarding their understanding of home care ratings and the “magic list”. The results are surprising:

The Home Healthcare List

  • Most but not all consumers recalled receiving the “magic list”.
  • Most case managers report that the lists they provide were not informative and didn’t give the information patients need to make an informed choice.
  • Case managers use the list to uphold “Patient Choice” laws.
  • When probed about the specifics of the laws governing choice, case managers’ responses varied, and no one cited the Social Security Act.
  • Almost all the case managers felt that agencies were of similar quality and reported there was no feedback once a patient was discharged. (Like a thank you letter or phone followup from the Agency)
  • Of the 13 consumers, NONE knew about Medicare home health agency public reports.

Check out the direct quotes from consumers pulled from the previously quoted study:

  • “[There are reports for nursing homes, but] I haven’t seen anything from home health care.
  • “I’d be interested in the subjective quality rating from [other] patients.”
  • “I wasn’t familiar with any of them, so I chose [agency] because [they were] the closest.”

And quotes from Case Managers:

  • “I tell them that most of the agencies are the same.”
  • “We say, ‘I can’t recommend, but I can inform you.’”
  • “It’s by word of mouth kind of referral. Talk to your family. Talk to your doctors’ office if you are that unsure about what to do.”

Helping Patients Pick An Agency

Case managers are worried about violating patient choice and as such may not even discuss star ratings. See this blog post discussing the topic in detail A Perfectly Legal Way to Help Patients Pick Higher-Quality Post-Acute Providers. In short, some case managers are overly concerned about patient choice, resulting in absolutely no discussion regarding how to search for an agency and no mention of the Medicare star ratings.  Of note, both medical providers and case managers can mention that Medicare star ratings exist. In no way does mentioning a government sanctioned rating remove the freedom of patient choice.

Customers look for several things when searching for home care agencies, you will notice a "Star Rating" is at the bottom of the list:

  • Word of mouth from Doctors (aka the Fountain of Youth/Holy Grail that may not exist) see our previous post on why getting in with the doc may not be the best way to get referrals. How To Get Home Health Referrals from Doctors
  • Word of mouth from friends + family.
  • Safety including background checks, training, and freedom from liability. It is up to you as an owner or marketer to convey this to the consumer.
  • Transparency of cost. Cost of care is one of the top concerns for consumers. Avoid last minute "sticker shock". Be transparent about your pricing and help families understand that home care is often times much cheaper than a nursing home or a trip to the hospital.
  • Excellent customer support.
  • And finally internet ratings - you will note that a star rating is on the bottom of this list! It matters but not as much as delivering quality, reliable and cost-effective home care.

So why the disconnect? We know that star ratings tend to be useful - simply ask anyone who sells or buys on Amazon. The problem with home care is that these ratings are not easily seen and no one knows about them. Go ahead, try it yourself, search 10 local agencies and try to find their star rating. Sure you can pull up the Medicare home health compare site, enter in your zip code and then CTRL-f the agency name while simultaneously searching their website and calling the agency. It's not as easy as Amazon, especially if it is your first time purchasing care.

Now go look at your website, is the star rating plastered front and center on the home page? Is it at bottom of the page or not even on your site?

So what is the implication behind all of this? Well, while it would be nice if star ratings were more well known, that does not seem to be the case. Focusing on this rating as the key to your agencies success is not the best way to get customers not to run a great agency. Instead, focus on understanding your customer's journey. Know ALL your referral sources. Gather data on all your sales funnels and give EXCELLENT care, no matter what the star says.

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