Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
Rural Medicare beneficiaries receive care from home health agencies (HHAs) located in both rural and urban communities. Over one-fifth of urban HHAs have patient populations consisting of 10% or more rural beneficiaries and can be considered rural-serving along with rural HHAs.
In this policy brief, we examine variation in Medicare star ratings for HHAs by rural-serving status. While the quality of patient care star ratings were not significantly associated with rural-serving status, patient experience star ratings were higher among rural-serving HHAs. Rural-serving urban HHAs were almost twice as likely to have high patient experience star ratings compared to non-rural-serving urban HHAs. HHAs located in large, small, and isolated small rural communities were even more likely to have high patient experience star ratings compared to non-rural-serving urban HHAs, and the likelihood of high ratings increased as rurality increased. Quality of patient care and patient experience star ratings are capturing different domains of quality and rural-serving HHAs outperform non-rural-serving HHAs on patient experience star ratings.