Home Health Value-Based Purchasing

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Effective January 1, 2015, the CMS Innovation Center implemented the Home Health Value-Based Purchasing (HHVBP) Model to support the IHI Triple Aim through greater quality and efficiency of care among Medicare-certified Home Health Agencies (HHAs).

WHY

All HHAs in the nine states participating in the HHVBP Model will have payment tied to their quality performance. The schedule for adjustments is as follows:
  • a maximum payment adjustment of 3 percent (upward or downward) in 2018;
  • a maximum payment adjustment of 5 percent (upward or downward) in 2019; 
  • a maximum payment adjustment of 6 percent (upward or downward) in 2020; 
  • a maximum payment adjustment of 7 percent (upward or downward) in 2021; and 
  • a maximum payment adjustment of 8 percent (upward or downward) in 2022.

WHO

Effective January 1, 2016, CMS began modifying payments to Medicare-certified home health agencies in nine states (MA, MD, NC, FL, WA, AZ, IA, NE, TN) through the HHVBP Model.

WHEN

HHVBP became effective January 1, 2016 for HHAs in the nine states participating in the pilot. Adjustment for reimbursement will begin in 2018.

TO DO

HHAs who provide services in one or more of the nine states participating in the HHVBP Model should:

  1. Provide a primary point of contact to the CMS HHVBP Help Desk.
  2. Create an account on the CMS Portal, where you'll receive performance reports and enter data for measures.

RISK

Reimbursement for services is directly tied to quality performance. In 2018, payment will be adjusted by a maximum of +/- 3%, moving to a maximum adjustment of +/- 8% in 2022.
 

ADDITIONAL RESOURCES

VNAA-Developed Resources
VNAA Healthcare Transofrmation e-Toolkit
Webinar Archive: Advancing Access to High-Quality Home-Based Care - The VNAA Healthcare Transformation e-Toolkit
Webinar Archive: HHVBP Model 101
Webinar Archive: Performance Improvement 101
Webinar Archive: Measuring Performance Improvement
Webinar Archive: Performance Improvement 102
Public Resources
Home Health Value-Based Purchasing Model (CMS)
The Home Health Value-Based Purchasing (HHVBP) Model Overview (CMS)
Report to Congress: Plan to Implement a Medicare Home Health Agency Value-Based Purchasing Program (HHS)
Partner Resources
Webinar Archive: How Value-Based Purchasing Affects You (Axxess)
Home Health Value Based Purchasing: What You Need to Know
Value Based Purchasing Program Affects Home Health Agency Reimbursement (CliftonLarsonAllen)
Other Resources (may include a fee to access)
   

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