Consistency of Home Health Performance Associated With Joint Commission Accreditation Status

Abstract

The CMS Home Health Quality Reporting Program (HH QRP) requires home health agencies (HHAs) to report quality data to measure their performance. This study aimed to assess the relationship between voluntary accreditation with The Joint Commission (TJC) and the ability of HHAs to sustain higher performance over multiple years compared to non-TJC-accredited HHAs. This was a multi-year observational study that analyzed CMS HHA performance data for each year, 2013 to 2019. Measures of interest were the star ratings and 8 quality measures in the HHC dataset with enough variability where a difference between the top and bottom quartile would be meaningful. Close to half of HHAs did not attain the top quartile for any of the study years, but TJC-accredited HHAs generally have a lower proportion of HHAs with 0 year and a higher proportion with 4 to 7 years with top-quartile performance for all measures except the 2 immunization measures. Given a HHA was in the top quartile on a measure the previous year, TJC-accredited HHAs were significantly more likely to remain in the top quartile the year following compared to non-TJC-accredited HHAs. These findings demonstrate better sustained performance among TJC-accredited HHAs compared to non-TJC-accredited agencies. These findings suggest that accreditation requirements may address some of the factors that can threaten the sustainability of positive performance in HHAs. Further research is needed to explore these factors more closely.