Summary of the 2023 Health Equity Confidential Feedback Reports for Home Health Agencies
Summary of the 2023 Health Equity Confidential Feedback Reports for Home Health Agencies
In October 2023, the Centers for Medicare & Medicaid Services (CMS) released the 2023 Health Equity Confidential Feedback Reports, providing crucial insights into disparities in care outcomes across post-acute care (PAC) settings, including home health agencies (HHAs). The reports focus on two critical measures: Discharge to Community (DTC) and Medicare Spending Per Beneficiary (MSPB), both stratified by dual-enrollment status and race/ethnicity.
Key Findings for Home Health Agencies
The national DTC rates revealed significant disparities, with dual-enrolled and Non-White patients experiencing lower rates of successful discharge to the community compared to non-duals and White patients. Within individual HHAs, dual-enrolled patients frequently had worse DTC outcomes than non-duals, while disparities based on race/ethnicity were more varied. In some cases, Non-White patients had outcomes similar to or better than White patients, indicating variability depending on specific populations and providers. Additionally, agencies with higher proportions of dual-enrolled or Non-White patients tended to have lower DTC rates, suggesting that the presence of socially at-risk patients could negatively impact discharge success.
For the MSPB measure, which reflects Medicare spending during and after the treatment period, the data showed less pronounced disparities in HHAs compared to other PAC settings. While dual-enrolled patients generally had worse MSPB outcomes within individual HHAs, the spending for Non-White patients was often similar to or better than that for White patients, indicating that racial and ethnic disparities in spending are less consistent in home health. However, as with DTC, MSPB outcomes tended to worsen as the proportion of dual-enrolled or Non-White patients increased within an agency.
- Related: HHAs Report Better Post-Acute Outcomes Versus Other Facilities (HomeCare, 8/23/24)
Conclusion and Implications
The 2023 Health Equity Confidential Feedback Reports highlight significant disparities in DTC and MSPB outcomes for dual-enrolled and Non-White patients within HHAs, particularly among dual-enrolled patients who faced lower DTC rates and higher MSPB amounts. These findings underscore the need for targeted, equity-focused strategies to improve care outcomes for these populations, especially as their presence within an agency increases the challenges in achieving successful community discharges and managing Medicare spending.