The Home Health Value-Based Purchasing (HHVBP) Model was implemented by The Center for Medicare and Medicaid Innovation in 2016 and stayed in place through December 31, 2021. The model aimed to support higher-quality care in Medicare-certified Home Health Agencies (HHA) as well as to improve efficiency in this part of the healthcare industry.
The HHVBP Model has been expanded nationwide, with 2022 serving as the pre-implementation year. Since 2023, health services have been required to participate if they meet CMS requirements.
Home Health Value Based Purchasing 101
The CMS Home Health Value Based Purchasing measures have several purposes. The first was to create incentives that would encourage better quality care via home healthcare services serving Medicare beneficiaries. The second was to improve the public reporting process. The last purpose was to study quality and efficiency measures to determine which could be used in home health settings to improve efficiency and care across the board.
Only nine states implemented the original Home Health Value Based Purchasing program, including:
- Arizona
- Florida
- Iowa
- Maryland
- Massachusetts
- Nebraska
- North Carolina
- Tennessee
- Washington
It wasn't until January 2021 that the CMS decided to expand the model nationwide. The nationwide model went into place in 2022.
Home Health Value Based Purchasing Model Definition
A simple definition of the Home Health Value Based Purchasing Model is that it's a set of quality measures put into place to encourage providers to improve care within home healthcare environments serving Medicare beneficiaries.
Previously, the CMS found that Medicare beneficiaries in fee-for-service systems often dealt with uncoordinated care, an increased number of emergency room visits, and other inadequate types of care. The HHVBP Model was successful and resulted in:
- Fewer unnecessary emergency room visits
- Reduced Medicare spending
- Improved patient mobility
The results of the HHVBP's initial launch were clearly beneficial to Medicare recipients. The original model led to a 4.6% improvement in the quality scores earned by home health agencies. Medicare also saved an additional $141 million, which led to the expanded HHVBP Model's release nationwide.
How Does the HHVBP Model Work?
The HHVBP operates by adjusting payments to HHAs for services based on how well they deliver care. It won't be the standard to focus on quantity like in the past. Instead, the model looks at how many quality services were provided and of what quality those services were over a length of time. In addition, the HHVBP also looks at incentivizing home health agencies by testing if larger incentives for better care result in improved outcomes.
What Are the Goals of the HHVBP Model?
The HHVBP Model is important because it focuses on quality care among home health agencies. Through this model, agencies that offer better-quality care earn higher incentives. Medicare saves money with this model because higher-quality care leads to healthier home health patients, which means patients are less likely to need hospitalization or other more expensive services.
Overall, the goal is to improve efficiency while guaranteeing quality care and a better patient experience for those who receive support through Medicare-certified HHAs.
How to Start Implementing the HHVBP Model
Tracking and reporting Medicare's requirements has always been challenging, but it is one to overcome to ensure good quality of care within the health industry. The HHVBP Model provides home health agencies with opportunities to earn financial incentives when they make quality improvements compared to other agencies in the field. Participation is mandatory for all Medicare-certified home health agencies with a CMS certification number (CCN).
There are two primary steps to get started:
- Contact the Centers for Medicare & Medicaid Services and let the CMS know your primary point of contact. You should provide the CMS with your CMS Certification Number and the name, phone number, and address of your HHA.
- Get online and go to the CMS Secure Portal. You will need to register an account within the HHVBP Model's data portal.
For more details on getting started online, you can reach out to the HHVBP Help Desk.
Once you've done all this, to implement the HHVBP Model, you will have to track the HHVBP components and aim to meet the individual measures set by the CMS. Each category of measures is weighted, and the score you receive in each will add up to give you a percentage out of 100. That percentage is your Total Performance Score (TPS) and shows your overall quality performance and how you can improve patients' interactions with care providers.
To learn more about the exact requirements, you can review this educational resource with the individual categories and scoring system broken down for you.
The Home Health Value Based Purchasing (HHVBP) Model empowers healthcare professionals to provide better care while tracking and reporting as required within today's evolving healthcare reimbursement framework. At WorldView, we offer an all-in-one, efficient platform with the digital tools you need to stay ahead of changes in Medicare guidelines, tracking, reporting, and more so your business's home health care process flow is as easy as possible. Learn more about WorldView today.
