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Dataset: Home Health Compare (HHC)

Basic Information
Dataset Full Name Home Health Compare
Dataset Acronym HHC
Summary

The Home Health Compare (HHC) database contains home health agency level data. Data are collected from summarized patient assessments and Medicare claims. It is designed to allow patients and their caregivers the ability to compare home health agencies on outcome measures and process of care measures. The Home Health Compare datasets include a subset of Outcome and Assessment Information Set (OASIS) based quality performance measures collected by the Centers for Medicare and Medicaid Services (CMS). It includes both process of care and outcome of care measures:

  • Process of care measures: how often an agency gave the recommended care (like checking patients for depression when they start getting care). A score of 88% for a process of care measure is interpreted as 88% of the patients received that recommended care during their episode of care.
  • Outcome of care measures: the results of the care an agency provided compared to other agencies, taking into account differences in the patients they care for. An agency’s score of 58% for an outcome measure means that 58% of the time the Home Health Agency was able to assist their patients in regaining or maintaining their ability to function during their episode of care, such as improve their ability to walk and move around.


Note that no patient level data is available. All data is aggregated at the national, state and individual Health Care agency levels.
Key Terms Home Health Agency Performance, Quality of Patient Care, OASIS, Health Care Utilization, Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS), Patient satisfaction with home health care, home health care, national outcomes, state outcomes.
Study Design Longitudinal
Data Type(s) Administrative
Sponsoring Agency/Entity Centers for Medicare & Medicaid Services (CMS); Department of Health and Human Services (HHS)
Health Conditions/Disability Measures
Health Condition(s) NA
Disability Measures NA
Measures/Outcomes of Interest
Topics State and regional variations in home health care quality, use of recommended processes, improvement in outcome measures
Health Services Utilization, Hospitalization rates, Quality of Home Health Care, Patient Satisfaction and Experience with Care, Patient-Provider Communication

Process Measures: Timely initiation of care, Influenza immunization received for current flu season, Pneumococcal polysaccharide vaccine ever received, Diabetic foot care and patient education implemented, Depression assessment conducted, Drug education on all medications provided to patient/caregiver, Multifactor fall risk assessment conducted for all patients who can ambulate.

Outcome Measures: Improvement in ambulation, Improvement in bed transfer, Improvement in pain interfering with activity, Improvement in bathing, Improvement in management of oral medications, Improvement in dyspnea, Improvement in status of surgical wounds, Improvement in breathing, Improvement in pressure ulcers, Acute care hospitalizations, Emergency department use without hospitalization, Emergency department use without hospital readmission during the first 30 days of home health
Sample
Sample Population

 All Medicare-certified home health care agencies nationally.
Sample Size/Notes 11,181 (January 2020) All Medicare certified home health agencies
Number of agencies varies by year
Aggregated rates from the HHCAHPS patient survey are calculated from a randomly selected sample of patients for each agency.
Unit of Observation Service Provider
Continent(s) North America
Countries

United States
Geographic Coverage National
Geographic Specificity Individual Home Health Care agencies
Data Collection
Data Collection Mode Administrative claims data
Mail, phone or mixed mode interview
Assessment based on review of patient records and observation (subset of OASIS)
Years Collected 2003-present
Data Collection Frequency Quarterly
Strengths and Limitations
Strengths Data include all Medicare-certified HHAs and are ideal for doing research on regional variation and services utilization.
Data can be linked with other CMS datasets.
Rates calculated from OASIS data are risk-adjusted to make comparisons between health agencies possible.
Comparisons can be made on national/state/facility level for different time periods.
Limitations Patient-level data not available.
Several quality measures have been revised over time and may not be comparable across all time periods.
Outcome of care and utilization measures are risk-adjusted, however bias could still be introduced from other unadjusted characteristics of the patients or the agencies, e.g. an agency only accepting patients who have a better prognosis for specific conditions.
Data limited to Medicare beneficiaries and Medicare certified agencies only, not necessarily representative of all home health patients and providers.
Data Details
Primary Website https://www.medicare.gov/homehealthcompare/search.html
Data Access Current period data:
https://data.medicare.gov/data/home-health-compare

Archived data:
https://data.medicare.gov/data/archives/home-health-compare
Data Access Requirements Public Use Dataset
Summary Tables/Reports National and State averages for HHC data:
https://data.medicare.gov/data/home-health-compare
Data Components

Data files available as Microsoft Access files or csv FlatFiles.


Comprised of 8 files:

1. HHC_SOCRATA_PRVDR.csv: Home health agency information including: the type of patient services offered, the values of the star rating and patient outcome and process quality measures.
2. HHC_SOCRATA_STATE.csv: State averages for the patient outcome and process measures
3. HHHC_SOCRATA_NATIONAL.csv: National averages for the patient outcome and process measures
4. HHC_SOCRATA_ZIP.csv: Information on the areas (by zip code) served by the home health agency based on OASIS assessments
5. HHC_SOCRATA_HHCAHPS_PRVDR.csv: Patient Experience of Care Survey results for each home health agency.
6. HHC_SOCRATA_HHCAHPS_NATIONAL.csv: National averages for the patient experience of care survey measures
7. HHC_SOCRATA_HHCAHPS_STATE.csv: State averages for the patient experience of care survey measures
8. HHC_SOCRATA_MSR_DT_RNG.csv: Beginning and end dates of the data collection period for each Home Health Compare measure.
Similar/Related Dataset(s)

Inpatient Rehabilitation Facility Compare

Nursing Home Compare
Selected Papers
Other Papers Home Health Compare web site offers critical information to consumers, professionals:
https://www.ncbi.nlm.nih.gov/pubmed/15192503

Agency Characteristics and Changes in Home Health Quality After Home Health Compare:
https://www.ncbi.nlm.nih.gov/pubmed/20231725
Technical Statistical methods:
https://www.medicare.gov/HomeHealthCompare/Data/Statistical-Methods.html

Risk adjustment of outcome measures:
https://www.medicare.gov/HomeHealthCompare/Data/Risk-Adjustment.html

Rate calculations:
https://www.medicare.gov/HomeHealthCompare/Data/Rate-Calculation.html

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The Rehabilitation Research Cross-dataset Variable Catalog has been developed through the Center for Large Data Research & Data Sharing in Rehabilitation (CLDR). The Center for Large Data Research and Data Sharing in Rehabilitation involves a consortium of investigators from the University of Texas Medical Branch, Cornell University's Yang Tan Institute (YTI), and the University of Michigan. The CLDR is funded by NIH - National Institute of Child Health and Human Development, through the National Center for Medical Rehabilitation Research, the National Institute for Neurological Disorders and Stroke, and the National Institute of Biomedical Imaging and Bioengineering. (P2CHD065702).

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Acknowledgements: This tool was developed through the efforts of William Erickson and Arun Karpur, and web designers Jason Criss and Jeff Trondsen at Cornell University. Many thanks to graduate students Kyoung Jo Oh and Yeong Joon Yoon who developed much of the content used in this tool.

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