The Home Health Value Based Purchasing (HHVBP) program is a model required by the Accountable Care Act that CMS is hoping will result in better delivery of care, better outcomes and reduced costs; it is anticipated to be the most significant change to Medicare since 2000. The model requires home health providers in nine states to fulfill a mandate that intertwines quality and payment. Based on performance, experience and outcomes, payment adjustments will incentivize providers by financially rewarding those who meet and beat the quality standards, while those who fail to meet the standards are left with lower payment revenues. These standards are based off information gathered from 10 process measures, 15 outcome measures, and four new measures coming from OASIS, Medicare claims data, and HHCAHPS. The CMS estimates that the model will result in $380 million in savings with the reduction of unnecessary hospital readmissions.

Who is currently participating in the program?

On January 1, 2016, the following nine states (randomly chosen) began mandatory participation in the HHVBP pilot program from all Medicare-certified home health associations:

  • Arizona
  • Iowa
  • Florida
  • Massachusetts
  • Maryland
  • Nebraska
  • North Carolina
  • Tennessee
  • Washington

Even if you are not in a state, we can help prepare you for improved outcomes.

How can Eventium help?

Patient Education

Patient education is the cornerstone of disease management and population management. Standardized patient education
facilitates shared decision-making and empowers patients to manage their own health and get better!

Click below to view our patient education tools that support success in Home Health Value Based Purchasing.

View VBP Tools


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What will be measured?

The HH-VBP model utilizes data from OASIS, Medicare claims, Home Health CAHPS surveys and other directly reported data to evaluate HHAs on a specific set of 24 measures:

Outcome Measures (CASPER reports):
Improvement in Ambulation (M1860)
Improvement in Bed Transferring (M1850)
Improvement in Bathing (M1830)
Improvement in Dyspnea (M1400)
Discharged to Community (M2420
Acute Care Hospitalization (Claims)
ER Utilization without Hospitalization (Claims)
Improvement in Pain with Activity (M1242)
Improved Management of Oral Medications (M2020)
Prior Functioning ADL/IADL (M1900)
NOTE: This measure is not currently reported

Process Measures (CASPER reports):
Care Management-Types/Sources of Assistance (M2102)
Influenza Data Collection Period (M1041)
Influenza Immunization Received for Current Flu Season (M1046)
Pneumococcal Vaccine Ever Received (M1051)
Reason Pneumococcal Not Received (M1056)
Drug Education on All Medications Provided to the Patient/Caregiver (M2015)

Home Health CAHPS Satisfaction Survey Measures:
Communication between Providers and Patients
Specific Care Issues
Overall Rating of Home Health Care
Willingness to Recommend the Agency

Agency-Reported Measures (NEW):
Influenza Vaccination Coverage for Home Health Personnel
Herpes Zoster (Shingles) Vaccination Ever Received by Patient
Advance Care Planning