stethoscope and piggy bank

A new study supports the benefits of value-based purchasing (HHVBP) just a few months before Medicare will require home health providers nationwide to adopt the model.

In an analysis of 16.5 million patients who received home health between 2013 and 2021, those who were in nine states piloting Medicare’s HHVBP model had lower utilization rates for hospitals and skilled nursing facilities. The study suggests that financial incentives tied to home health quality performance were associated with reduced Medicare spending, while improving or maintaining the quality of care. 

In the study, 22.6% of patients reviewed lived in the nine states piloting HHVBP, while 77.4% lived in states outside the pilot program. Overall, unplanned hospitalizations dropped by 0.15% in the HHVBP states and the use of SNFs declined by 0.34%. States in the pilot program were associated with a reduction in daily Medicare payments of $2.17 due primarily to reduced inpatient and SNF services. The reduction helped save Medicare approximately $190 million annually. 

In both groups, inpatient services accounted for the most spending with home healthcare services accounting for the second largest spend.

Home health value-based purchasing will launch in all 50 states on Jan. 1, following a successful pilot that began in 2015 in  Florida, Iowa, Massachusetts, Arizona, Maryland, Nebraska, North Carolina, Tennessee and Washington. 

The study supports a report released earlier this year by the Centers for Medicare & Medicaid Services. In its fifth annual report on the HHVBP model, CMS found agencies participating in the nine pilot states performed 7% better than those operating outside the test sites. The report also found that home health agencies in the nine HHVBP states experienced fewer inpatient and skilled nursing facility visits, a decrease in patient hospitalizations and improvement in the functional status of patients released back into the community. In total, those agencies saved Medicare about $950 million between 2016 and 2020.