CMS Seeks to Grow Purchasing Model Based on Home Health
Monday, January 25th, 2021

Earlier this month, the federal government announced via email that it plans to extend the Home Health Value-Based Purchase Model (HHVBP) through rulemaking starting no earlier than January of next year. The model is now being applied in nine states and has led to an overall increase of nearly five percent in service ratings for home health providers and more than $140 million in annual savings from Medicare.

The HHVBP model has been part of the broader, ongoing transition from volume to value-based care by the federal government. CMS launched the initiative in 2016 to incentivize home health providers to better the quality of care and decrease spending on Medicare.

HHVBP is compulsory in select states where incentives are adjusted based on quality results compared to peers in the state for Medicare-certified home health agencies. Florida, Iowa, Maryland, North Carolina, Tennessee, and Washington are among these states.

For example, in 2018, home health providers involved in the model achieved a median of three percent Medicare rate change (up and down) based on average results across 20 quality measures, including hospital-free utilization of emergency rooms, oral medication management, and urgent care hospitalizations during the first 60 days of home health care.

The maximal positive and negative payout adjustment has been raised by CMS each year, with the peak adjustment at six percent for the most recent performance period. Next year, the department plans to lift to eight percent the maximum positive and negative adjustment.

To read more, visit https://revcycleintelligence.com/news/cms-to-expand-home-health-value-based-purchasing-model.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.