Data Sources and Scoring Criteria

Where does our data come from?

Our scoring and rankings are based on data sets provided and maintained by the Centers for Medicare and Medicaid Services (CMS). Below are their data sets we make use of:

What date range does our site cover?

The latest public CAHPS and HIS data from CMS covers the year of 2019.

How often is the data on our site updated?

CMS maintains a reporting schedule and performs an annual data refresh in November for the preceding year. The most recent data we have covers 2019 and was released in November 2020 by CMS. Due to the COVID-19 epidemic, CMS has put a freeze on reporting new HQRP data to the public until February 2022.

How do we calculate Caregiver Ratings?

In order to stay compliant with the Hospice Quality Reporting Program (HQRP), hospice providers must submit their survey data from the Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS®) to CMS on a monthly basis. The survey is made up of 47 questions covering the experience of family caregivers and hospice patients.

We compare each hospice provider’s latest CAHPS survey results with the average results of their state and then translate each score into a star rating. If you hover over the stars, we also display each of the provider’s CAHPS scores next to the State’s average for that score.

To learn more about CAHPS, visit the CMS website.

How do we calculate Quality of Patient Care scores?

In order to stay compliant with the Hospice Quality Reporting Program (HQRP), hospice providers must submit results from their Hospice Item Set (HIS) survey data directly to CMS. HIS data is used to calculate the quality of care that a hospice patient receives.

We compare each hospice provider’s latest HIS survey results with the average results of their state and then translate each score into a star rating. If you hover over the stars, we also display each of the provider’s HIS scores next to the State’s average for that score.

To learn more about the HIS quality measures, visit the CMS website.

Why are our scores relative to state averages?

Open Caregiving chooses to present scores relative to state averages in an effort to help caregivers make an educated decision when choosing a hospice provider in their area.

While comparing scores nationally may be helpful for context, most individuals entering hospice care cannot move to a different part of the country so we believe comparing scores on a state level offers the most practical guidance we can provide for caregivers and their loved ones.

How do we calculate our overall hospice star rating?

We use the latest publicly available HQRP survey data reported by CMS to create our overall star rating. We take each quality dimension into account and use min-max normalization coupled with weighted measures to produce a single quality score for each provider. We then compare this single score to each provider that serves an area based on CMS’ ZIP Data. We display the highest scoring providers at the top of search results.

Why are some providers missing Caregiver Experience scores?

Hospice providers that do not have any caregiver experience scores are typically either exempt (due to their small size) or not compliant with the Hospice Quality Reporting Program (HQRP).

Hospice providers that care for less than 50 patients in a given year can apply for an exemption.

If a provider does not have a certain score, scroll over the “Not Available” badge where we attempt to explain why there is no score. The reasons they may not have a score include:

  • The number of completed questionnaires doesn’t meet the required minimum amount for public reporting for this reporting period.
  • The agency didn’t submit any required data for this reporting period.
  • The results were based on fewer than all possible quarters of data for the reporting period.
  • The results for these measures were excluded for various reasons, like data inaccuracies.
  • There were deviations from data collection protocols.
  • The agency is too new or too small to be required to participate in the CAHPS® Hospice Survey, or no cases met the criteria for the measures for this reporting period.

Why are some providers missing Quality of Care scores?

Hospice providers that do not have any quality of care scores are typically either exempt (due to their small size) or not compliant with the Hospice Quality Reporting Program (HQRP).

Hospice providers with a Quality Measure denominator size of less than 20 patient stays (based on 12 rolling months of data) will not have the Quality Measure score publicly displayed since the sample size is too small to determine an accurate score.

If a provider does not have a certain score, scroll over the “Not Available” badge where we attempt to explain why there is no score. The reasons they may not have a score include:

  • The number of patient stays doesn’t meet the required minimum amount for public reporting for this reporting period.
  • The provider didn’t submit required data for this quality reporting period.
  • The provider has been Medicare-certified for less than 6 months OR there wasn’t data to submit for this measure for this reporting period.
  • The results for these quality measures were excluded due to data issues beyond the hospice’s control.
  • The results were based upon less than 12 months of data.

What does it mean for a provider to be HQRP compliant?

If a provider submits timely and complete survey data for both CAHPS® & HIS then they are compliant with HQRP requirements. CMS uses a “pay-for-reporting” model which means CMS does not determine hospice providers payment rates based on performance. As long as they report their survey data on a timely basis, their market basket updates/Annual Payment Updates (APU) are not effected.

Non-exempt Hospice providers that fail to submit required quality data are incurred a 2 percentage-point reduction in payments.

What does it mean for a provider to be Open Caregiving verified?

Verified providers have reached out directly to Open Caregiving to confirm the information on their profile or correct any inaccuracies. Verified providers can also add additional information about their offings, specialties, staff and facility that may help caregivers make a more educated decision when choosing hospice care.

All information that is added by a verified hospice provider is first reviewed by the Open Caregiving team to confirm validity.

I’m a hospice provider, how do I verify my information?

To verify your hospice profile, email [email protected] with the name of your hospice provider and your title.