Comparing Public Quality Ratings for Joint Commission Accredited and Non-Joint Commission Accredited Home Health Agencies: A Replication Study

Abstract

This was a descriptive replication study comparing 2083 home health agencies accredited by The Joint Commission (TJC) and 8695 non-TJC-accredited home health agencies over a 3-year period using the Centers for Medicare and Medicaid Services Home Health Compare data set. Metrics included the star ratings and 17 quality measures. A longitudinal model was used to determine differences between TJC-accredited and non-TJC-accredited organizations on the quality measures. Categorical differences in star ratings were analyzed using a Cochran-Mantel-Haenszel test. TJC-accredited home health agencies had better average ratings than non-TJC-accredited home health agencies for each of the 3 years (3.4 vs 3.2, p < .001). When categories were collapsed to evaluate differences, the analysis revealed that a significantly larger proportion of TJC-accredited facilities were clustered within the higher ratings (41% for TJC-accredited vs 32% for non-TJC-accredited), and fewer TJC-accredited organizations were clustered within the lower ratings (22% for TJC-accredited vs 30% for non-TJC-accredited; p < .001). Two claims-based outcome measures (hospitalization and emergency room visits) were consistent with the original study in which TJC-accredited home health organizations had statistically significant lower rates across all 3 years studied, compared to non-TJC-accredited HHAs. This replication study validates and extends the generalizability of the findings from the original study.