Hopefully you're familiar with the Home Care Compare (HCC) project-an integral part of CMS's Quality Initiative. This project involves public reporting of home care quality measures using OASIS data and the OBQI process to measure an individual agency's performance so consumers can choose the best agency. Piloted in eight states in the spring, the measures were to be reported nationwide by mid October, 2003. There will be an evaluative process because there are several concerns about the program:

1. Reliability of the OASIS Tool: While the move to OBQI has been a very positive step, concerns remain that the OASIS tool continues to challenge providers. Because the entire OBQI project hinges on OASIS, questions about interrater reliability-the ability to obtain reliable OASIS scores between clinicians-need to be addressed.

2. Small Agency Nonreporting on Home Care Compare: CMS will report data of agencies with a sufficient number of episodes to be statistically sound. Its rationale: smaller sample sizes would have a tendency to be misleading. However, there are concerns about leaving these providers off the list.CMS convened focus groups of consumers/caregivers to evaluate the HCC Web site to determine how they would use the tool in choosing an agency for their loved one. Participants said they would exclude providers with low quality indicators and that agencies with no data would be suspicious.

3. Language Changes from OASIS Tool to Public Reporting: There were several language changes to make the information consumer friendly. These changes, while necessary for public understanding, could result in a significant difference between the OASIS items measured in the home versus the indicator reported to the public.

4. The choice of the Quality Indicator Items as Indicative of Home Care Services: The quality measures available for the public to examine include:

[black small square] four measures related to improvement in getting around,

[black small square] four measures related to meeting the patient's ADLs,

[black small square] two measures related to patient medical emergencies, and

[black small square] one measure related to improvement in mental health.

The home care industry has worked diligently over the past 20 years to educate consumers about the services and support home care can provide for everyone, not just the elderly and infirmed. Consumers who look only at these indicators will likely have difficulty evaluating how home care can work with their younger, acutely ill family member. The HCC Web site states, "The information in HCC should be...used with other information you gather about...agencies as you decide where to get home health services. You may want to contact your doctor, your State Survey Agency or your State Quality Improvement Organization (QIO) for more information."

Become involved and suggest ways data in this program can be improved. For more information on Home Care Compare visit http://www.medicare.gov.