State: Sample State (XX)
Agencies Tracked: 838
Generated: April 27, 2026
SeniorIndex — Institutional Grade Intelligence
Data Vintage
Quality & HHCAHPSCMS PDC, April 2026
HHVBP PerformanceCMS Performance Year 2025
Cost data (HCRIS)FY2025
Agency ScoreSeniorIndex composite, April 2026
Each layer refreshed at the fastest cadence CMS publishes. Quality & HHCAHPS data releases annually; HHVBP performance scores publish each performance year; HCRIS cost data posts annually with an ~18-month lag.
838
Total HH Agencies
CMS-certified, OH
27%
VBP Participants
228 of 838 agencies
$101
Avg Cost Per Visit
-$38.10 vs national avg
41.2
Avg Quality Score
National avg: 48.7
Market Size
838
CMS-certified HH agencies
228 VBP participants (27.2%)
140 with HCRIS cost data (16.7%)
Avg Quality Score
41.2
vs 48.7 national average
Cost Per Visit
$101
State avg | National: $139
-$38.10 vs national average
Ownership Composition
| Ownership Type |
Agencies |
Distribution |
Share |
| PROPRIETARY |
697 |
|
83.2% |
| NON-PROFIT |
80 |
|
9.5% |
| Unknown |
52 |
|
6.2% |
| GOVERNMENT OPERATED |
9 |
|
1.1% |
SeniorIndex Grade Distribution
B (Above Average)
113 (13.5%)
D (Below Average)
550 (65.6%)
CMS Quality Star Ratings
★★★★★ (5.0-star)
9 (1.1%)
★★★★½ (4.5-star)
25 (3.0%)
★★★★☆ (4.0-star)
28 (3.3%)
★★★½☆ (3.5-star)
62 (7.4%)
★★★☆☆ (3.0-star)
41 (4.9%)
★★½☆☆ (2.5-star)
39 (4.7%)
★★☆☆☆ (2.0-star)
19 (2.3%)
★½☆☆☆ (1.5-star)
17 (2.0%)
★☆☆☆☆ (1.0-star)
5 (0.6%)
Market Quality Profile: Of 838 Sample State home health agencies,
21 (2.5%) hold A-tier ratings,
113 (13.5%) B-tier, and
564 (67.3%) fall below the C threshold.
The Sample State market quality average of 41.2 compares to a national average of 48.7.
Agencies ranked by SeniorIndex overall quality score. VBP payment adjustment reflects CMS Performance Year 2025 determination.
| # |
Agency Name |
City |
Grade |
Quality Score |
VBP Adj. |
Cost/Visit |
| 1 |
Agency 1 |
City 1 |
A
|
86.1 |
+4.46% |
$38.39 |
| 2 |
Agency 2 |
City 2 |
A
|
84.9 |
+4.31% |
N/A |
| 3 |
Agency 3 |
City 3 |
A
|
84.8 |
+2.31% |
$21.55 |
| 4 |
Agency 4 |
City 4 |
A-
|
82.6 |
+5.00% |
$43.80 |
| 5 |
Agency 5 |
City 5 |
A-
|
82.5 |
+3.19% |
$50.76 |
| 6 |
Agency 6 |
City 6 |
A-
|
82.5 |
+0.85% |
$33.47 |
| 7 |
Agency 7 |
City 7 |
A-
|
81.3 |
+5.00% |
$14.26 |
| 8 |
Agency 8 |
City 8 |
A-
|
81.3 |
+2.85% |
$49.92 |
| 9 |
Agency 9 |
City 9 |
A-
|
81.0 |
+1.82% |
N/A |
| 10 |
Agency 10 |
City 10 |
A-
|
80.3 |
+0.42% |
$40.66 |
| 11 |
Agency 11 |
City 11 |
A-
|
80.1 |
-0.65% |
$696.24 |
| 12 |
Agency 12 |
City 12 |
A-
|
80.0 |
+0.59% |
$65.64 |
| 13 |
Agency 13 |
City 13 |
A-
|
80.0 |
+0.56% |
$94.98 |
| 14 |
Agency 14 |
City 14 |
A-
|
79.7 |
+0.41% |
$84.29 |
| 15 |
Agency 15 |
City 15 |
A-
|
79.5 |
+4.64% |
$86.78 |
Participants
228
27.2% of XX agencies
Avg Total Performance Score
30.9
National avg: 34.9
Avg Payment Adjustment
-0.24%
National avg: +0.30%
Payment Adjustment Distribution (228 participants)
■ Positive adjustment (100 agencies)
■ Neutral (1 agencies)
■ Negative adjustment (127 agencies)
Top VBP Performers — Sample State
| Agency Name |
City |
Total Perf. Score |
Payment Adj. |
Cohort |
| Agency 7 |
City 7 |
76.7 |
+5.00% |
Smaller-volume |
| Agency 16 |
City 16 |
75.5 |
+5.00% |
Smaller-volume |
| Agency 17 |
City 17 |
70.8 |
+5.00% |
Larger-volume |
| Agency 18 |
City 9 |
69.5 |
+5.00% |
Larger-volume |
| Agency 4 |
City 4 |
68.5 |
+5.00% |
Larger-volume |
| Agency 19 |
City 18 |
65.5 |
+5.00% |
Larger-volume |
| Agency 20 |
City 19 |
64.8 |
+5.00% |
Larger-volume |
| Agency 15 |
City 15 |
61.7 |
+4.64% |
Larger-volume |
VBP Context: 610 Sample State agencies (72.8%) are exempt from HHVBP — typically due to insufficient episode volume, recent certification, or territory exclusion. CMS withholds payment adjustments for these providers; absence from VBP does not indicate poor quality.
Avg Cost Per Visit
$101.01
National avg: $139.11
-$38.10 vs national
Median Cost Per Visit
$75.36
HCRIS FY2025, outliers excluded ($50–$1,000)
HCRIS Coverage
140
16.7% of XX agencies
Average Revenue Mix (Sample State)
Medicare84.0%
Medicaid14.5%
Private Pay / Other3.1%
Based on 140 Sample State agencies with FY2025 HCRIS cost report data.
698 agencies lack cost report data (excluded from financial calculations).
Top 5 Agency Visit Share
20.6%
of 5,582,333 total documented visits (OH, HCRIS agencies)
Market Structure
Fragmented — top 5 agencies control <30% of visit volume, indicating a competitive market.
Largest Agencies by Visit Volume (Sample State)
| # |
Agency Name |
City |
Ownership |
Annual Visits |
Revenue |
Grade |
| 1 |
Agency 21 |
City 20 |
NON-PROFIT |
|
N/A |
A-
|
| 2 |
Agency 22 |
City 21 |
PROPRIETARY |
|
N/A |
C+
|
| 3 |
Agency 7 |
City 7 |
PROPRIETARY |
|
N/A |
A-
|
| 4 |
Agency 23 |
City 22 |
NON-PROFIT |
|
N/A |
B-
|
| 5 |
Agency 24 |
City 23 |
PROPRIETARY |
|
N/A |
B
|
| 6 |
Agency 3 |
City 3 |
PROPRIETARY |
|
N/A |
A
|
| 7 |
Agency 25 |
City 24 |
PROPRIETARY |
|
N/A |
D
|
| 8 |
Agency 26 |
City 25 |
PROPRIETARY |
|
N/A |
B-
|
| 9 |
Agency 27 |
City 26 |
NON-PROFIT |
|
N/A |
B
|
| 10 |
Agency 28 |
City 27 |
PROPRIETARY |
|
N/A |
C-
|
Visit volume from CMS HCRIS FY2025. Agencies without cost reports are excluded from concentration analysis.
| Dataset | Source | Vintage | Coverage |
|---|
| Agency Registry & Quality Measures | CMS PDC #6jpm-sxkc | April 2026 | 838 agencies |
| Patient Survey (HHCAHPS) | CMS PDC #ccn4-8vby | April 2026 | Agencies with sufficient volume |
| HHVBP Performance | CMS PDC #56d7-4994 | Performance Year 2025 | 228 participants |
| Cost Reports (HCRIS) | CMS HCRIS HHA20FY2025.ZIP | FY2025 | 140 agencies (16.7%) |
| SeniorIndex Agency Score | SeniorIndex computed metric | April 2026 | All 838 agencies |
SeniorIndex Agency Score is a composite metric computed from CMS quality measures, HHCAHPS patient experience data, HHVBP performance scores, and HCRIS cost efficiency data. Non-VBP participants receive national median VBP score (not zero) to avoid penalizing agencies that lack episode volume to qualify. Cost per visit outliers beyond $50–$1,000 are excluded. See full methodology at
seniorindex.ai/methodology.html.