Joint Commission Accreditation, Higher Public Quality Ratings Linked

Joint Commission-accredited home health agencies performed statistically higher than non-accredited agencies on federal quality of patient care star ratings and quality measures over a three-year period, according to a new study published by Home Health Care Management & Practice.

The peer-reviewed study, “Comparing Public Quality Ratings for Accredited and Non-accredited Home Health Agencies,” concludes that underlying factors associated with the differences are not well established, and additional research is needed to explore the specific mechanisms that lead to better quality and safety. 

However, the relationship between Joint Commission accreditation and home health agency quality is consistent with findings in other health care settings, including hospitals, nursing homes, and behavioral health care organizations.

While more than 100 published studies have linked Joint Commission accreditation to higher quality outcomes, the new study is the first to evaluate the relationship between accreditation and public quality metrics in the home health setting.

The study used publicly available data from the Centers for Medicare and Medicaid Services (CMS) including Home Health Compare star ratings and 22 quality measures for 1,582 accredited and 10,008 non-accredited home health agencies for 2013, 2014 and 2015.

The quality of patient care star rating is a summary measure of a home health agency’s performance on individual quality measures such as timely initiation of care, drug education on all medications provided to patients/caregivers, influenza immunizations received for the current flu season, improvement in ambulation, and acute care hospitalization.

Accredited agencies received statistically higher star ratings than non-accredited organizations, and were more likely to be categorized 4, 4.5, or 5 star organizations, on a scale of 1 to 5 stars.

Absolute differences between accredited and non-accredited agencies on CMS Outcome and Assessment Information Set (OASIS) quality measures were generally small but consistently favored accredited facilities over all three years studied.

“It is important to interpret these results with some degree of caution, as the study was not designed to explain why accredited home health agencies outperformed non-accredited agencies,” said Scott C. Williams, PsyD, director of Health Services Research at the Joint Commission, and lead study author.  “Nevertheless, we were struck by how robust the findings were – as Joint Commission accredited agencies consistently outperformed non-accredited agencies in each of the three years studied.”

More than 5,400 home care agencies in the United States hold Joint Commission Home Care Accreditation, having undergone survey to demonstrate compliance with rigorous accreditation standards.

The standards focus on processes for patient safety and performance excellence in areas such hand-off communication, medication management, leadership, staffing, equipment maintenance, fall risk reduction and patient engagement and education.

Last month, the California Department of Public Health approved Joint Commission accreditation as an option for home health licensure and re-licensure in the state. For more information about Joint Commission Home Care Accreditation, visit www.jointcommission.org/homecare.

Source: Joint Commission