Remember those days in school when you received your report card? Whether it was elementary, middle, high school, or college, the day the grades came out was a veritable day of reckoning. When you were younger, you always wondered how your parents would react. In high school, being too smart could mean you'd lose friends so maybe you wouldn't tell anyone the grades you really made. In college, especially if you were getting reimbursement from an employer or a scholarship, making As and Bs was your only option, so the pressure was on.

Although grades often aren't the truest measure of what we've learned and how educated we are, they are a necessary evil to which we've all adjusted. Well, now it's time to get ready for CMS to post the grades of home health agencies, planned for distribution in October, 2003. A home health agency's quality indicators as reported through the OBQI process by the federal government will be used by consumers, payers, and others to indicate agencies in a specific area rank with their peers.

In late November of 2002 outcome results from the nursing home industry began being reported in newspapers, Web sites, and on television. HHS Secretary Tommy Thompson and CMS Administrator Tom Scully have appeared on numerous media outlining the process and sharing with consumers that these data are providing the public an important tool in evaluating healthcare providers. Additionally, they predict that the reports will provide motivation for healthcare providers to become better at what they do. The government's objective is that those providers that are unable to improve will likely leave the industry.

The nursing home reports include information about the percentage of patients in restraints, bedsores, and the number of hours of care provided to a patient every day. The report also shares information about the homes that sought help from their Quality Improvement Organizations (QIOs). In Colorado, for example, only 50 of 225 facilities sought help from their QIO prior to the reports being publicized.

In home care we have our own QIOs that are beginning to actively work directly with agencies in every state to improve the quality of services. In the August and September 2002 OBQI issues of HHN, the Practical Application section of each of six stages of the OBQI process discussed the positive impact of the Delmarva Foundation; the home care QIO that worked with agencies in the demonstration project.

Home care agencies should actively work with their QIOs and assessing the resources available in Mary Weakland's (2002) article. If you're interested in seeing how the nursing home reports look before the home care report is posted (as planned for October 2003), visit http://www.medicare.gov or call (800) MEDICARE to have a report mailed to you.

There are opportunities to prepare by looking at the reports, talking with our nursing home friends, and examining the impact these cards have on referral sources, payers, and consumers. Look for more information about these reports in upcoming issues of HHN.

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