​home healthcare based on best not ownership


there are 100 medicare qualified home health agencies in Connecticut according to medicare.gov.  Home health agencies are evaluated by outcomes designated by medicare.  They are broken down into categories, Quality of Patient Care and Patient Survey.

Under Quality there are many categories that are requested by Medicare. Some of the important ones (in my view) are 

How Often patients wounds improved or healed after surgery?

Some of the top agencies are

Interim - 100% of their patients

Hebrew Healthcare -97.3%

Farmington VNA - 91.7% of their patients

Hartford Health at Home - 89.9%

                   Connecticut Average is 90.8%

                   National Average is 89.4%

Data collection on re-admissions to the hospital is a key issue that all are working towards.  

How Often home health patients had to be admitted to the hospital (lower is better)

   Farmington VNA- 12.4%   Interim-15.6%   Hartford Healthcare at Home-17.6%   Hebrew Healthcare-19.8%              Connecticut Average - 16.8%              National Average - 15.9%

 How often home health patients, who have had a recent hospital stay, had to be re-admitted to the hospital (there is no number connected to these yet)


Hebrew Healthcare - Same as expected

Farmington VNA - Same as Expected

Interim Healthcare – Same as expected

Hartford Healthcare at Home-worse than expected

So for me this begs the question as to why we don't refer patients to those agencies that have the best outcomes? It doesn't happen and even worse if someone goes to the hospital with an active agency it is probable that this patient will leave with a referral to the agency that the hospital owns. There is no  process of evaluating which agency is better with outcomes than the other and apparently no interest either.  If the goal is to improve the patient when they leave to go home then the agency involved should be one that has the best outcomes for that particular issue. There are other data that are also collected related to pulmonary issues, cardiac issues, diabetes, ambulation, emergency department visits and much more. So let's me be clear. There are only 100 agencies in Connecticut and plenty of patients to go around. Is it fair for the hospitals, short term care and physician practices to be directed to whom they refer to? Is it right for patients to not be aware that one agency may have better outcomes than other agencies? Perhaps there should be a list of preferred agencies that the providers give and review with patients and families so there is a better understanding on who is going to care for them when they go home and why the hospital is recommending them.