woman receiving healthcare visit

A new report from the Center for Medicare & Medicaid Innovation offers encouraging news to home health providers who will start participating in Medicare’s value-based purchasing program next year. 

The fifth annual report found agencies participating in CMMI’s Home Health Value-Based Purchasing (HHVBP) Model in nine states are performing 7% better than other home health agencies operating outside the mode. The participating agencies also saved Medicare nearly $950 million between 2016 and 2020. Moreover, the report found that home health agencies participating in HHVBP saw a decrease in inpatient and skilled nursing facility visits, a decrease in patient hospitalizations and improvement in the functional status of patients released back into the community. 

“Our continued findings of reductions in unplanned hospitalizations and in Medicare spending for inpatient services provide evidence of the HHVBP Model’s achievement of intended impacts,” the report stated. 

In 2016, CMMI launched the home health value-based purchasing model in Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee and Washington. The Centers for Medicare & Medicaid Services announced late last year it would expand the program nationwide in 2023. 

Value-based purchasing rewards agencies based on the quality of care they provide rather than the volume of care. Payment adjustments are determined based on how a home health agency performs against other agencies in its state on a dozen measures that make up a total performance score (TPS). That means agencies that outperform or underperform will receive either an upward payment adjustment or a penalty. The model’s payment adjustment increased each year, with agencies getting up to a 3% increase in 2018 and up to a 7% increase in 2021.

Related Articles