Consistency and Sustainability of Home Health Agency Patient Experience Star Rating Performance and the Association With Joint Commission Accreditation

Abstract

Accreditation seeks to improve the quality of health care, 1 dimension of which is patient experience. The Home Health Consumer Assessment of Healthcare Practitioners and Systems (HHCAHPS) survey collects patient care experience data in home health agencies (HHAs). This study examined the association between accreditation and the consistency and sustainability of high patient experience ratings between Joint Commission (TJC)-accredited and non-TJC accredited HHAs. This multi-year observational study analyzed HHCAHPS star rating performance data from 2015 to 2019. The 5 measures included are based on the 3 publicly reported composite measures, the global measure, and a Star Summary measure. Each measure receives a star rating from 1 to 5. A total of 7230 HHAs reported star rating data between 2015 and 2019, with 4099 (56.7%) having data spanning all 5 years. Of these, 959 (23.4%) were TJC-accredited and 3140 (76.6%) were not. A star rating score of 4 or 5 was considered high performing. TJC-accredited (vs non-TJC accredited) organizations had a higher proportion of HHAs with all 5 years with a high rating ( p < .05 for all measures). Among those HHAs who were in the top rating category the previous year, TJC-accredited (vs non-TJC accredited) HHAs had an even higher probability of sustaining the top rating category in the current year ( p < .001 for all measures). These findings suggest that TJC accreditation is associated with consistently high HHCAHPS star ratings over time. This association was strongest for the Specific Care Issues measure where the concepts addressed by the measure overlapped with topics addressed by accreditation standards.