Methodology
All metrics and change events are calculated deterministically in code. Language models never invent report facts. HMG is operated by ExtraSphere Media LLC and is not affiliated with CMS, HRSA, or other government agencies.
Product lines use product-specific geography and thresholds: Home Health (≥3 agencies serving via service ZIP), Hospice (≥2 facilities located in county), Skilled Nursing (≥3 facilities), HPSA (≥1 active designation). Missing ratings are never treated as zeros.
How markets are built
- Markets are U.S. counties (FIPS).
- Service-area analysis maps each CMS-reported home health service ZIP to a primary county using HUD-USPS total-address ratios (residential ratio then county FIPS as deterministic tie-breakers).
- An agency is counted as serving a county when at least one reported service ZIP maps to that county.
- Headquarters location uses the provider address ZIP mapped with the same crosswalk.
- All headline metrics and change events are calculated deterministically in code or SQL—never by a language model.
- A county report is sellable only when demographics exist, at least three Medicare-certified agencies report service, QA passes, and payload validation succeeds.
- Free previews show limited metrics and the first five agency rows; the paid PDF includes the full table and change detail.
- County quality-measure and HHCAHPS-composite figures are medians across agencies serving the county; coverage percentages state how many agencies report each measure, and missing values are never imputed.
- State and national benchmarks are medians and Hazen percentiles across counties with a computable value in the loaded dataset; state percentiles are suppressed when fewer than 10 counties in the state report the metric.
- Medicare utilization context joins the CMS Post-Acute Care HHA PUF (CY2023) by CCN; PUF totals cover each agency's entire service area because the PUF publishes no county-level rows.
Definitions
- Agencies serving
- Distinct Medicare-certified home health agencies with at least one CMS-reported service ZIP whose primary county equals the market county.
- Agencies headquartered
- Distinct agencies whose provider-address ZIP primary county equals the market county.
- Reported ZIP coverage
- Count of CMS-listed service ZIPs that map to the market county. Not volume, census, capacity, or market share.
- Material change
- A comparable field difference between two published bundles that meets configured materiality rules (for example star moves of 0.5+, ownership change, add/remove from service set).
- Coverage percent
- Share of agencies serving the county that report a given measure. Missing or suppressed values are excluded from medians, never counted as zero.
- Episode HHI
- Herfindahl-Hirschman index over PUF episode shares of agencies serving the county (0-10,000; higher = more concentrated). Provider-level episodes, not county-allocated volumes.
Limitations
- Agency service presence is based on CMS-reported service ZIP codes mapped to a primary county via HUD-USPS crosswalk ratios; it is not confirmed capacity.
- Star ratings and survey measures can be missing, suppressed, or delayed relative to operations.
- Ownership types and names are as reported in public CMS files and may lag legal or branding changes.
- Demographic figures come from Census ACS estimates and carry sampling error.
- Change events compare two comparable published source bundles only; missing values are never treated as zeros or declines.
- Sorting in agency tables is for readability only and is not an HMG ranking or recommendation.
- Medicare PAC PUF figures are provider-level Fee-for-Service totals for CY2023 (the latest published year, roughly a two-year lag) and are not county-allocated.
- State and national benchmark medians and percentiles are computed from the counties present in the loaded dataset, not from a fixed universe estimate.
Disclaimers
- This product uses public data and HMG-derived calculations.
- HMG is not affiliated with or endorsed by CMS, HHS, HUD, or the Census Bureau.
- Reported ZIP coverage does not prove current availability or acceptance of a particular patient.
- Public ratings and survey results reflect stated measurement periods and may not represent current operations.
- Missing or suppressed data does not mean poor performance.
- This report is business and market information, not medical, legal, compliance, reimbursement, or investment advice.