Home health providers aiming to achieve success under the Home Health Value-Based Purchase (HHVBP) model should implement clinical strategies that will help improve scores.
According to Chris Attaya, vice president of product strategy for the Data Analytics Company Strategic Healthcare program, detail-oriented providers who commit to daily and weekly data reviews can see efforts that pay off with notable bonuses.
US Centers for Medicare & Medicaid Services (CMS) expanded its HHVBP nationwide in 2021. This model has been an active demonstration in nine states since 2016 before this expansion.
In this model, home health providers are incentivized or penalized according to many performance measures for maximum upward or downward Medicare fee adjustments of 5%. In 2025, HHVBP has dropped from 12 measures to 10.
According to Attaya, avoiding preventable hospitalization is one of the best clinical strategies to improve performance scores under HHVBP.
“Of course you want to keep them away from the (Emergency Department) (ed.), so you can avoid them being put in observation beds,” he said in a presentation at the Home Care at Home Financial Summit in July.
Also important is understanding patient risks and addressing them in a care plan as part of episode management.
“It's everyone's job to communicate when something is going on to make sure the clinicians, aides and teams know and help them stay home,” Attaya said.
Hospitalization review is another strategic tool to ensure strong clinical outcomes.
“It's really important because we're trying to delve into the commonality of hospitalized patients and decide,” Attaya said. “What was their diagnosis? Is there anything in our care plan that we need to fine-tune or update? Is that what's going on with one of my teams? Is that what's going on with a few clinicians? Go back and look at the last 10-14 days.”
Attaya noted that providers can make hospitalization retrospectives part of the organization's quality assurance and performance improvement (QAPI) program.
Providers should also utilize hospitalization risk predictors, Attaya noted. Some EMR vendors offer this solution, Attaya pointed out.
Improving consumer ratings for emissions processes and oasis competencies, as well as healthcare providers and systems (CAHPS) scores, should also be a provider's top priority when it comes to HHVBP.
Ultimately, the most detailed-oriented providers are well positioned to work well under HHVBP.
“One of the agencies I talked about was getting a 5% bonus,” Attaya said. “They've been persistent about digging in detail on a regular basis, which doesn't mean, 'I'm going to do it once a quarter.' Fresh, persistent in the matter, look at real-time results data.
