Several agencies have attested that the Home Health Value-Based Purchasing (HHVBP) initiative has meaningfully improved the quality of care for their patients. There has been a decline in the re-hospitalization of home health patients, which led to an average of 141 million dollars of yearly savings on Medicare spending. Moreover, the average improvement for quality scores with the HHVBP pilot was 4.6%.
With 2022 being the pre-implementation year, CMS is expected to provide resources and training to allow home health agencies to prepare and learn about the expectations and requirements of the expanded HHVBP Model without risk to payments. Agencies must be on the lookout for significant adjustments in the benchmarking process.
HHVBP Measures and Scoring
Essentially, home health agencies would receive a total performance score (TPS) based on their performance in comparison to their improvement score and other agencies’ performance (achievement score); the higher of the two would constitute the TPS. The baseline year used for the comparison starting January 2022 would be the agency’s performance in 2019. Improvement and achievement scores will determine whether the agency wins or loses up to 5% in dollars for 2022, which will be reflected in 2024.
Below are the quality measures that impact the calculation of the Total Performance Scores (TPS):
Next Steps to Take
It is best to be ready for the HHVBP expansion. Below are specific steps providers can take to prepare:
- Examine performance for the year 2019
- Compare 2021 scores to the baseline year of 2019 to gauge improvement score
- Compare 2021 scores to the national scores for 2019 (benchmark) to gauge achievement score
- Identify measures that need the most attention
- Develop a performance improvement plan to address them
- Set targets for improvement and track monthly
Gather your scores for the measures above. The calculation of these scores is available via your partner for quality outcome measurement, or via agency VBP reports if you are currently in a VBP state.
With these changes, it is important to enlist help as much as you can to take advantage of the incentives from the HHVBP program. Home health agencies must leverage their QA to optimize their scores on the set quality measures. Your QA review program can significantly help improve and maintain the quality of your patient care documentation. QA providers can contribute helpful insights on areas that require improvement, as well as provide support in other aspects, such as reeducation of clinicians on more complex issues.
Harness HHVBP to Your Advantage
HHVBP is a challenge and an opportunity for agencies at the same time. While it is intended to drive savings in Medicare utilization of healthcare services, it also provides incentives for home health agencies that deliver quality patient care. With the right approach, HHVBP can inspire business growth for home health agencies while also stimulating excellent healthcare services. It is an opportune time to explore growth opportunities that also lay the groundwork for quality patient care to flourish.