CMS Releases Preview of Home Health Value-Based Purchasing Performance Reports

McKnight’s Home Care | By Adam Healy
 
Providers can now examine their Preview Annual Performance Reports for the Home Health Value-Based Purchasing (HHVBP) model, which will be crucial for determining potential reimbursement changes taking effect next year, according to home care consulting firm Healthcare Provider Solutions.
 
“This preview report introduces, for the first time, the percentage calculations showing how your 2023 results will affect your 2025 payments,” Melinda Gaboury, the cofounder and chief executive officer of Healthcare Provider Solutions, explained Monday. “It’s crucial that you review these reports right away, especially if you’ve been monitoring your calculations and believe there may be errors.” 
 
The Centers for Medicare & Medicaid Services uses claims data, Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) surveys and Outcome and Assessment Information Set (OASIS) results to score providers under HHVBP. Those who rank within the 51st percentile or higher will see either no change in their future reimbursement or a payment increase of up to 5%. However, providers that are scored at the 50th percentile and below will have their payment reduced between 0.2% and 5%. 
“Make sure to thoroughly review the content, especially focusing on the measures where your performance has fallen short,” Gaboury recommended. “As you review each individual element and its percentile ranking, aim for each measure to fall within the 50th to 75th percentiles to ensure your overall score is moving in the right direction.”
 
Experts recently offered strategies for achieving the best results under HHVBP at the National Association for Home Care & Hospice’s 2024 Financial Management Conference in Las Vegas. The most important quality measure affecting providers’ HHVBP scores is their rate of acute care hospitalization claims, so using tools like remote patient monitoring can help rein in avoidable hospitalizations, they said.
 
CMS is accepting requests for score recalculations up to Sept. 7, Gaboury noted. On Sept. 27, CMS is expected to release Preliminary Annual Performance reports, and on Dec. 2, it will send out the final reports. The reports are available in the Internet Quality Improvement & Evaluation System (iQIES), according to CMS.