The latest version of the Interim Performance Report (IPR) for HHVBP is set to be available in iQIES by end of January 2024. It allows agencies to evaluate and monitor their quality measure performance compared to peers in their cohort. The January 2024 IPR will also feature additional data for CY 2023, serving as the basis for the adjusted payment percentage in CY 2025.

The January 2024 IPR will include data from the following timeframes for the 12 measures in the expanded HHVBP model:

(5) OASIS-based quality measures – 10/1/2022 to 9/30/2023
(2) Claims-based – 7/1/2022 to 6/30/2023
(5) HHCAHPS Survey-based quality measures – 7/1/2022 to 6/30/2023

Reviewing IPR contents

The quarterly IPRs contain each agency’s updated quality measure performance based on the last 12 months of data available  including:

• A quarterly update on the HHA’s interim Total Performance Score (TPS)
• Percentile rankings reflecting HHA performance relative to other HHAs in the cohort
• TNC Change Reference tab to identify HHA performance on the 9 individual OASIS items included in the two TNC Change measures
• Scorecard tab to identify how each individual measure contributes to the HHA’s TPS

Here’s how the IPRs differ from other reports found in iQIES:

• Uses performance in the HHVBP Model measure set to calculate the HHA’s interim TPS
• The Interim Performance Report provides a peer ranking of HHAs that belong to the same cohort based on their performance on the HHVBP set measures.
• Informs the HHA about the percentage of quality episodes wherein there was no change, positive change, or negative change for each of the nine OASIS items utilized in the two TNC Change measures.

The iQIES reports and the HHVBP reports may also result from the different data collection date ranges used in reports as well as risk adjustment. For example, the iQIES Review and Correct Reports use observed measure values and expanded Model performance reports use risk-adjusted values.

The initial version of the quarterly IPR, called the Preliminary IPR, allows HHAs to request a recalculation if they believe there’s a discrepancy in performance scores. To file a dispute based on the Preliminary IPR, the agency must submit a recalculation request within 15 calendar days of its publication. The Value-Based Purchasing June newsletter contains detailed instructions, including links to the appropriate platform for submitting recalculation requests.

All HHAs that received a Preliminary IPR will receive a Final IPR even if the HHA did not submit a recalculation request. Read this report from CMS for an overview of the HHVBP Model Measures and Reports.

The post Reviewing the January 2024 IPR for HHVBP first appeared on Qavalo.

The 2024 Home Health Final Payment Rule, released on November 1, 2023, brings significant changes directly impacting the Value-Based Purchasing (VBP) model in 2025. We have summarized these changes and added some notes about their implications.

While VBP generally stays the same in 2024, maintaining the 2022 baseline, the changes will be brought about by the five outcome measures being replaced by three new ones. This shift will adjust the weight of individual items, affecting the Total Performance Scores (TPS). Importantly, the method for calculating HHCAHPS measures and their 6% contribution to the Total Performance Score remains unchanged.

1. The new Discharge Function Score (DFS) will replace the existing Total Normalized Composite Change in Self-Care and Total Normalized Composite Change in Mobility measures, which depend on the 1800 items on the OASIS.
   
   This new Discharge Function Score measure will be solely based on GG0130 and GG0170 items. Specifically, only Eating, Oral Hygiene, and Toileting Hygiene from GG0130 will be used in calculating this score.
   
   The Discharge Function Score based on GG items, uses patient info from the Start of Care or Resumption of Care OASIS in a new CMS algorithm. This algorithm predicts the expected discharge status based on the documented patient status during SOC or ROC.  If the agency’s reported discharge status matches or exceeds the algorithm’s calculation after submitting the Discharge OASIS, it leads to a positive measure outcome.
   
   
2. A new Discharge to Community-Post Acute Care (DTC-PAC) measure, which will then utilize claims data, will replace the current OASIS-based Discharge to Community (DTC) measure.
   
   This change impacts Value-Based Purchasing calculations, with the new measure using a 2-year data span instead of 12 months.
   
3. A new single Potentially Preventable Hospitalization (PPH) measure will consolidate the existing Acute Care Hospitalization (ACH) and Emergency Department (ED) measures. The PPH, combined with the Discharge to Community-Post Acute Care Measure, will constitute the claims data for the VBP model.
   
   Keep in mind that the PPH measure incorporates Observation stays. Consequently, if a patient under Home Health care undergoes an Acute Care Hospitalization or Observation stay, it will adversely affect the measure outcome.
   
4. Both the Improvement in Dyspnea and Improvement in Management of Oral Medications measures will continue to be included in the model, but there will be a slight adjustment to their weight impact on the overall TPS.

Preparing for the Changes

The changes to the Value-Based Purchasing model pose a challenge and require staff education by 2025, particularly focusing on GG items. This is crucial for sustaining success in the VBP mode considering the newly introduced measures. Nationwide data indicates a lack of sufficient education for GG items in the OASIS compared to ADLs in the M1800 section.

Home health agencies should ensure that their staff receives sufficient education as early as possible. In addition, utilize QA audits to help ensure accurate responses to GG items and support continuous learning for clinicians.

The post [CY 2024 Final Rule] Upcoming Changes to HHVBP first appeared on Qavalo.

The latest version of the Performance and Improvement Progress Report (PIPR) was released in April 2023, accessible through the iQIES system, your usual source for CASPER reports.

PIPRs show your current percentile ranking for each outcome measure when compared to agencies nationwide that belong to your cohort in the ongoing calculations for the 2023 Value-Based Purchasing expansion. The last 3 PIPRs are based on your data from the previous year through parts of 2022. 

Starting July 2023, PIPR featuring 2023 data will be released, featuring up-to-date achievement thresholds and benchmarks from the baseline year 2022. These reports will be used to calculate the outcomes for 2023.

To understand your organization’s standing relative to other agencies in specific outcome measures for the current year, it is crucial to review the PIPR reports as the expansion progresses. Suppose your measures rank at the 51st percentile or higher. In that case, you will likely earn the payment incentives once all 2023 data has been gathered and reimbursement impact calculation is done. 

Check CMS Website for HHVBP Related Updates

The Centers for Medicare & Medicaid Services (CMS) has a dedicated section for Value-Based Purchasing on its website. In a recently released April newsletter, CMS covers the updated resources on risk adjustment factors and modifications in the Home Health Quality Reporting program.  

Moreover, one of the updated documents focuses on risk adjustment, specifically discussing the risk adjustment factors that affect the calculation of Total Normalized Composite Change in Mobility and Self-Care Measure (TNC).  

CMS addresses the risk adjustment factor of excluding patients from calculations for Dyspnea, Oral Meds, the TNC measures, and Discharge to Community. Patients are excluded from these measure outcome calculations if they have been discharged to a non-institutional hospice. This positive development underscores the importance of understanding its implications on your outcome measures.

Utilize the following resources if you are interested in receiving additional information, updates or have questions about the Expanded Home Health Value-Based Purchasing Model:

• Listerserv: Subscribe to the HHVBP Model Expansion listserv
• Email questions to: HHVBPquestions@lewin.com

The post New PIPR is Out: What’s In It for You? first appeared on Qavalo.

To gear up for the implementation of the expanded home health value-based purchasing (HHVBP) model in 2023, the Centers for Medicare and Medicaid Services (CMS) has already issued the November 2022 Pre-Implementation Performance Report (PIPR) to all active home health agencies, which is now available to download iQIES Portal.

With the PIPRs, home health agencies are able to see their overall HHVBP quality measure performance in comparison to other agencies nationally within peer cohorts in the new baseline year of CY 2022. It is of utmost importance that agencies access this information as it is vital in anticipation of the release of the first Interim Performance Reports (IPRs) in July 2023. Hence, the HHVBP Technical Assistance team provided resources that provide instructions on how to access the PIPRs here, as well as information on the purpose, content, and use of the PIPRs here.

Harnessing HHVBP to Your Advantage

HHVBP is a double-edged sword, as it is a challenge and an opportunity for agencies simultaneously. However, with the right strategy, HHVBP can drive business growth and promote excellent healthcare services since it provides incentives for home health agencies that deliver quality patient care. The opportunity to explore growth opportunities is ripe for the taking.

Leveraging QA

Considering all the changes that are underway with the industry’s transition to value-based care, home health agencies can use all the help they can get to be at the winning end.

For one, your QA program can help optimize your data on OASIS-based measures used in the HHVP performance scoring. Your QA provider should be able to capture problem areas and support aspects like the re-education of clinicians for ongoing quality improvements in the documentation. These efforts will not only improve and maintain your documentation accuracy, but significantly contribute to earning incentives in the HHVBP game.

The post CMS Issues HHVBP Pre-Implementation Performance Report (PIPR) first appeared on Qavalo.

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.

Leveraging QA

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.

The post Gearing Up for HHVBP National Expansion: Where to Begin first appeared on Qavalo.