Understanding Home Health Value-Based Purchasing
The national expansion of Home Health Value-Based Purchasing (HHVBP) is expected to go into effect on January 1, 2022. To support your transition to the new model, we’ve teamed up with experts in home health operations, performance, and technology to develop a free, 8-week educational series: Countdown to Value-Based Purchasing: 8 steps toward success in 2022. This series will guide you through the key steps all home health agencies should take to prepare for success under HHVBP.
We’ll publish a brief summary of each week’s step, here on the WellSky Blog. Visit wellsky.com/HHVBP to access the full, in-depth guidance in videos and podcast episodes. You’ll also find a growing collection of additional free webinars, white papers, and success stories related to value-based performance initiatives.
The focus for this week is understanding the fundamentals of Home Health Value-Based Purchasing.
What is Home Health Value-Based Purchasing?
Value-based programs reward providers with incentive payments for the quality of care provided versus the quantity of care provided. Improving a patient’s health outcomes relative to the cost of care is beneficial across the healthcare system for patients, providers, health plans, employers, and government organizations.
Since the 2016 rollout of HHVBP in nine states, the model has resulted in an average 4.6 percent improvement in home health agencies’ quality scores and average annual Medicare savings of $141 million. This success has led to the proposed national expansion of the HHVBP model.
HHVBP timelines for agencies
The expanded model baseline year depends on your agency’s certification date and is your agency’s starting point for calculating your Total Performance Score (TPS). Because of minimums required within cohorts and state size, it is proposed that upon expansion of HHVBP, the cohorts are adjusted to be based nationally instead of by state, as some states did not meet minimum requirements. The landscape of competition is broadening.
In your first performance year, your outcomes will be compared against your baseline year outcomes relative to the competition benchmark. This flow chart outlines the calculations:
Achievement v. improvement
Even if your agency has a lower baseline year measure in some items, hope is not lost! There are two pathways to a higher TPS score: achievement and improvement. A few updates have been made to the outcome measures, terminology, and calculations to get to each agency’s TPS. The bottom line is, you must be able to improve, and the first steps of improvement are awareness and understanding.
Adjustments
The first adjustments will hit in 2024 with a maximum of +/- 5%, and agencies will be penalized or rewarded based on their scores in comparison to one another. With already tight margins, it will be tough for low-performing agencies to tolerate any negative adjustment.
Summary of the HHVBP model
The HHVBP model penalizes poorly performing agencies at a percentage of their baseline reimbursement. That bucket of money will then fund the incentive payment for the higher performing agencies across the nation.
Aligning your resources now to be competitive in the HHVBP model is vital. To best prepare for the payment shift, dig deep into your agency culture, organizational practices, data, and educational approaches to understand where you will stand in the competitive market. Most of you should already know your baseline year data. That’s where you start. Then, figure out what you need to do to maintain or improve your home health agency’s performance.
Next steps
For expanded guidance on the fundamentals of the HHVBP program and the concrete actions your agency should take to prepare, visit wellsky.com/HHVBP, and watch this week’s episode. Throughout this 8-week series, we will explore readying your agency to drive value in care provision to succeed under this competitive home health payment structure.