Home health service, when and where it's possible, is a preferred option for millions of Medicare beneficiaries, for reasons that should be self-evident. It's more convenient and certainly more comfortable for most people than being treated in a clinic, nursing home or hospital, not to mention saving patients the trouble and expense of getting there. And for the most part, the care is just as effective and of just as high quality as on-site services.
But a new Medicare ranking system compiled by Kaiser Health News offers a decidedly mixed assessment of the state of home health care in this area. That system ranks Georgia fourth-worst in the country in the percentage of home health agencies that earned superior (4- or 5-star) ratings. The evaluation is based on a combination of measures such as timely care; patient education about medications and drug interaction; reasonable improvement in patient mobility; pain management; patient hygiene, and hospital admission rates.
Interestingly, neither the low- nor the high-ranking states in this evaluation were necessarily among the "usual suspects" in either category: The four states ranked worse than Georgia, which had just 12 percent of its home health agencies with superior ratings, were Oregon, at 9 percent, Wyoming (4), Washington (3) and Alaska, with a flat zero.
By contrast, Alabama was among the states in which a third or more of its home health organizations received superior ratings, along with California, Florida, Maryland, New Jersey, Pennsylvania, Rhode Island, South Dakota and Utah.
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Obviously, there's an element of subjectivity to any such evaluation formula, however carefully it's compiled. There are no doubt substandard facilities in Alabama, and there are superior ones in Georgia and every other state (except, it would seem, Alaska). But in a realm of service where people can't really comparison shop, it's a starting point.
"It's not like a nursing home, where you can go and walk around," an executive for a nonprofit association for elder care was quoted as saying in the report. "You can call the agencies and find out a little bit about them and their philosophy of care, but even for an informed consumer like me, you're kind of stuck with whatever your physician has ordered."
You're also "stuck" with what some home health service agencies themselves want consumers to know. Some of these facilities report their own outcomes, with the result that ratings are not just subjective, but self-serving. Molly Smith of Visiting Nurse Associations of America told Georgia Health News, "Down the line, we are absolutely going to have to find another data source It really undermines the home health industry to always be reporting with data that has, yes, the potential to be manipulated."
Those caveats aside, it would seem the home care industry in Georgia has room for improvement, and might look just across the Chattahoochee for some good examples.