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Home Health Value-Based Purchasing Reports and How to Move the Needle

The shift to the new Home Health Value-Based Purchasing (HHVBP) Model can seem overwhelming. Deciphering reports to understand the impact of HHVBP isn’t easy but it can be done by understanding how scores are calculated. In fact, by using individualized plans of care and the 4M framework, it’s possible to improve outcomes enough to make a meaningful difference on VBP outcomes, according to experts who spoke during a recent Axxess webinar.

Experts outlined how to do this during a webinar featuring M. Aaron Little, CPA, Managing Director at FORVIS, and Teresa Harbour, RN, MBA, Chief Operating Officer at CHAP. Together, they explained the impact of HHVBP and how to adopt an age-friendly care approach to help businesses thrive in the model.

Understanding the Impact of HHVBP

In the model, home health agencies are scored on 12 different quality measures, which can impact their reimbursement rates from Medicare. The Total Performance Score (TPS), calculated on a scale of 0-100, is a crucial part of the model, with each measure contributing to it through achievement or improvement scores.

“Your performance here in [2023] will determine your payment adjustment for VBP purposes in [2025] of up to either a 5% increase or a 5% decrease or anywhere there in between,” explained Little.

This score is determined by the weighted sum of the 12 individual performance scores, emphasizing the value of constant improvement and high achievement. Little said providers need to understand the calculation of achievement points and improvement points.

“It’s based on the weighted sum of the 12 individual performance scores,” he said. “But for each of these metrics, there is both an achievement score and an improvement score, and essentially what that’s designed to do is to give each agency the opportunity to gain points on these measures by being a high achiever in relation to other agencies throughout the United States or by simply improving over their own score from [the baseline year].”

As part of the 2024 Home Health Final Rule, CMS will now use data organizations provided in 2023 to determine their baseline for increase or decrease. Previously, the baseline year was 2022.

Incorporating Age-Friendly Care

The concept of age-friendly care is an initiative that focuses on the unique needs of older adults. This approach is centered around the 4M framework: What Matters, Medication, Mentation, and Mobility.

“What matters to the patient gets aligned to that plan of care, and then gets pushed out to all clinicians,” said Harbour. She stressed that applying the 4M framework as a set, rather than individually, can result in improved outcomes and client satisfaction.

Harbour noted that age-friendly care doesn’t add work for the clinicians, but rather helps them organize their workflow.

“Patients don’t care how much you know until they know how much you care and this definitely shows patients that you do care about them because you’re developing the plan of care based on what matters to them,” said Harbour.

The age-friendly care approach is an initiative developed by the John A. Hartford Foundation, the Institute for Healthcare Improvement, the American Hospital Association and the Catholic Health Association. The work is based off research that helped to identify the unique needs of adults 65 years and older.

“Age-friendly care really goes hand in hand with patient-centered care,” said Harbour. “It’s evidence-based when you implement all the 4M as a set and show them that improved quality of care, decreased hospitalizations, decreased ER visits.”

To watch the full webinar explaining HHVBP and the 4M age-friendly care approach, click here.

Axxess Home Health, a cloud-based home health software, streamlines operations for every department while improving patient outcomes.


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