Expanded Home Health Value-Based Purchasing Model: HHVBP Newsletter – June 2022

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

The HHVBP Newsletter provides home health agencies (HHAs) with the latest information about the expanded HHVBP Model as well as important tools, news, and timely insights from the Centers for Medicare & Medicaid Services (CMS) and the HHVBP Model Technical Assistance (TA) Team. Please consider sharing this newsletter within your organization.

Information in the June 2022 edition of the newsletter includes the following:

HHVBP Model Highlights

Now Available: Evaluation of the Original Home Health Value-Based Purchasing Model – Fifth Annual Report

The Home Health Value-Based Purchasing Model – Fifth Annual Report is now available on the original HHVBP Model webpage (scroll down to the “Latest Evaluation Reports” section). The primary goals of this evaluation are to understand how the shift in financial incentives under the original HHVBP Model may influence HHA behavior and, in turn, the following aspects of home health care (as cited in the Findings-At-A-Glance Report):

  • Quality and utilization;
  • Medicare spending;
  • Patient experience with care and functional status; and
  • Equity and access.

This Annual Report focuses on the experience of home health patients and agencies through 2020, the third year that eligible agencies in the original HHVBP Model states received an adjustment to their Medicare payment amounts under the Home Health Prospective Payment System (HH PPS).

On the Horizon Coming Soon: Sample Reports – Interim Performance Report (IPR) and the Annual Total Performance Score and Payment Adjustment Report (Annual Report)

For learning purposes only, CMS will publish two sample reports in July – one for the IPR and one for the Annual Report. The sample reports are based on the same scoring methodologies and other policies presented in the Calendar Year (CY) 2022 Home Health Prospective Payment System (HH PPS) final rule.

The intent of these sample reports is to orient HHAs to the content and format of the performance feedback reports and help HHAs understand how CMS will assess HHA performance under the expanded HHVBP Model. These sample reports will not include actual HHA performance data. The sample reports will be made available to each competing HHA through iQIES. CMS will notify each competing HHA via email when the two reports are available.

In August, the HHVBP TA Team will host a live event designed to assist HHAs with understanding the format and content of the IPRs and Annual Report, using the sample reports as examples. Registration will be available soon. Upcoming Resources and Learning Events

In the coming months, the HHVBP TA team will release the following resources and learning products to assist HHAs with implementation of the expanded HHVBP Model, including the interpretation of performance feedback reports:

  • How Measure Performance Becomes Care Points: A video on how an HHA’s performance on a quality measure becomes the HHA’s achievement points, improvement points, and care points.
  • How Care Points Become the Total Performance Score (TPS): An on-demand recording and accompanying written resource reviewing the calculation of the TPS from care points.
  • How the Total Performance Score (TPS) Becomes the Final Payment Adjustment: An on-demand recording and accompanying written resource to help HHAs understand how the TPS translates into the adjusted payment percentage (APP) under the CY 2022 HH PPS final rule.

All resources will be available on the Expanded HHVBP Model webpage.

Resource Spotlight

New Resources and Learning Events Now Available

The following expanded HHVBP Model resources are now available on the Expanded HHVBP Model webpage:

  • June Edition of the FAQs
  • Expanded HHVBP Model Guide
  • HHVBP Model Composite Measure Calculation Steps
  • An Overview: Risk Adjustment Process and Use in the Expanded HHVBP Model
  • Making the Most of HHVBP Resources (instructional video)
  • Quality Measures Used in the Expanded HHVBP Model (instructional video)
  • How to use Existing Quality Assurance and Performance Improvement (QAPI) Processes to Support Improvement in Expanded Home Health Value-Based Purchasing (HHVBP) Model
  • Leadership and Communication—Essential Elements for Quality Improvement (podcast)

Literature Link: Health Equity

CCSQ’s Focus on Health Equity

In alignment with CMS’ programmatic vision of providing high-quality, equitable services, CCSQ pledged to advance health equity for those served through its models and initiatives, including the expanded HHVBP Model, by:

  1. Focusing on a person-centric approach as part of an overarching CMS Quality Strategy, which strives toward creating a care journey that is free from inequity while optimizing opportunities and access for underserved populations and
  2. Identifying measurable interventions to close gaps in quality care and outcomes.

In the CY 2022 HH PPS final rule, CMS outlined an improved data collection strategy to better understand the needs of HHAs and improve access to care for beneficiaries. According to the final rule, HHAs will begin reporting certain Standardized Patient Assessment Data Elements starting January 1, 2023. CMS also sought guidance on additional Standardized Patient Assessment Data Elements to assess health equity in the care of HHA patients. Through the comment period for the CY 2023 HH PPS proposed rule, CMS will continue to solicit comments and suggestions as the agency continues to develop policies that address health equity and SDOH.

2022 CMS Quality Conference: Advancing Health Equity

At the annual CMS Quality Conference Grand Plenary (Session #29), Jean Moody-Williams, Deputy Director of the Center for Clinical Standards and Quality (CCSQ), introduced the conference theme—New Hope, New Health: Charting a Path Forward—and announced the rollout of the CMS strategy: Advancing Health Equity Across CMS Programs and Policies. In addition, LaShawn McIver, Director of the CMS Office for Minority Health (OMH), outlined CMS’ pledge to advance health equity by:

  1. Designing, implementing, and operationalizing policies and programs that support health for all people served by CMS programs;
  2. Eliminating avoidable differences in health outcomes experienced by people who are disadvantaged or underserved; and
  3. Providing the care and support enrollees need to thrive.

Other sessions focused on health equity included:

  • Advancing Person-Centered Care through Quality and Health Equity (Session #8). Provided an overview of CMMI’s strategic direction to advance health equity. In this session, center leaders presented on current model efforts to achieve equitable outcomes through high quality, affordable, person-centered care. Dr. Dora Hughes, Chief Medical Officer at CMMI, discussed how CMMI is embedding health equity across the life cycle of its models.
  • Health Equity: Working Toward Equity Through Collaborative Action, Compassion, and Caring (Session #19). Organized by CCSQ, featured a discussion with speakers from different state and regional health initiatives working to create a culture of advancing equity. Presenters recommended the use of solutions customized to specific groups, as well as engaging with patients and community organizations as key stakeholders when developing quality improvement models and strategies.

All recorded sessions from the 2022 CMS Quality Conference are available at Quality Conference 2022 on Vimeo.

Contact Us

Please do not reply to this email. This is an unmonitored inbox. If you require assistance, use the following options:

  • For program questions about the expanded HHVBP Model, contact the HHVBP Help Desk at HHVBPquestions@lewin.com.
  • To receive email updates about expansion, please subscribe to the Expanded HHVBP Model listserv. Enter your email address in the contact form, then select “Home Health Value-Based Purchasing (HHVBP) Expanded Model” from the Innovations list.
  • For support with registration for the Internet Quality Improvement and Evaluation System (iQIES), please contact the QIES/iQIES Service Center by phone at (800) 339-9313 or by email at iqies@cms.hhs.gov. You may also refer to the iQIES Onboarding Guide posted to QTSO for registration support: https://qtso.cms.gov/software/iqies/reference-manuals.

Please contact the Home Health Quality Reporting Program (HH QRP) Help Desk at homehealthqualityquestions@cms.hhs.gov for questions about the following: Home Health Quality, including Care Compare (excluding HHCAHPS), OASIS coding and OASIS documentation, quality reporting requirements & deadlines, data reported in quality reports, measure calculations, Quality of Patient Care Star Rating (excluding suppressions requests), public reporting, risk adjustment, and Quality Assessment Only (QAO)/Pay for Reporting (P4P).