Home Health Data Release Gives New Insights to Building ACOs

The Centers for Medicare and Medicaid Services continued its transparency initiative as 2015 ended, releasing files with data covering home health agency performance in 2013. Who will use it, and will it provide value to the industry?


The Centers for Medicare and Medicaid Services did another “data dump” under its transparency initiative as 2015 ended, this time releasing the Medicare Home Health Agency Utilization and Payment Public Use File (PUF), covering home health agency performance in 2013.

The Medicare Part A institutional claims data is being offered to researchers, providers and other stakeholders, including consumers. This was the fourth release of massive sets of Medicare data during 2015, following the release of hospital, physician and Part B durable medical equipment information.

The latest release details care provided to fee-for-service Medicare beneficiaries; it includes information on more than 11,000 home health agencies, which filed more than 6 million claims and represent more than $18 billion in payments. The data covers such factors as utilization, payment and submitted charges by provider, state and home health resource group.

But it’s unsure to what extent home health agencies will know that the data is available and take advantage of it, an analyst says.

Many of the nation’s 11,000 home health agencies are small businesses, says Ann Olson, RN, a vice president and principal at Qualidigm, a home health research and consulting firm and a federal Quality Improvement Organization for New England providers.

Regardless of size, many of the organizations will use the data to assess their cost and efficiency status, because as accountable care organizations continue to form, other providers will be assessing home health agencies as they seek to create preferred provider networks, she adds.

Also See: CMS Releases 2013 Hospital, Physician Data

Currently, many of the organizations likely are not aware of the Medicare data dump, but will learn of it from state or national home health associations, Olson notes. Over time, many will take advantage of the data as the Accountable Care Act continues to move healthcare toward the Triple Aim of better health, better care and lower costs, as well as value-based purchasing, she contends.

While the release of data on home health agencies is from 2013 and a bit dated, it still provides transparency and gives some insight into the agencies, Olson says. Consequently, agencies approached by other provider organizations need to be ready to respond to where their metrics stand today, compared with the 2013 data. “Having this information released across all provider types is really setting the stage for communication and collaboration,” she adds.

Complicating matters for home health agencies and other providers who may partner with them is that the data is not risk-adjusted, so the case mix differences and variations are not reflected in the report. Consequently, comparisons with the data will be less than optimal. What is most important to other organizations is to see the movement of home health agencies toward achieving the Triple Aim, and this data can be one piece of the puzzle toward determining that, Olson says.

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