What Home Health Providers Are Learning From HHVBP’s First Full Year

Home Health Care News / By Patrick Filbin
 
In the midst of the first full performance year for the expanded Home Health Value-Based Purchasing (HHVBP) model, providers are figuring out where they are succeeding and where there is room for improvement.
 
HHVBP continues to save hundreds of millions of dollars each year, according to the U.S. Centers for Medicare & Medicaid Services (CMS).
 
And the initial set of HHVBP scores — on the provider side — is influencing the operations of home health providers of all sizes.
 
“We are steering the entire company towards value outcomes,” Ananth Mohan, COO of Elara Caring, told Home Health Care News. “It adds to the complexity of how we do business, so you have to be sophisticated about it. With the midway point scores, it’s really geared us up and reaffirms that this is the way the world’s going to go.”
 
HHVBP scores
 
The HHVBP model, which CMS expanded from nine demonstration states to home health agencies across the country on Jan. 1, 2023, was implemented to incentivize home health agencies to improve the quality of care they provide to Medicare beneficiaries.
 
The goal of the model is to link Medicare reimbursement to the quality of care, rather than just the quantity or volume of services.
 
The way CMS does that is through quality measures and performance scoring. Those measures include patient outcomes, patient experience, process measures and timely initiation of care.
 
Each category has specific measures that contribute to the overall performance score. The performance period usually lasts a year. During that time, CMS evaluates the data that providers share, and, from that, a score is returned to providers that can negatively or positively affect their reimbursement.
 
After reviewing the scores Elara Caring received at the six-month point, Mohan is pleased with the early results. In particular, Mohan is encouraged in how the results have affected day-to-day operations.
 
“On the hospitalization front, the results made us think about being more programmatic,” he said. “It changed how we think about centers of excellence around certain diseases, how we think about which areas of the company where we’re more hospital-heavy. It’s also changed the way we think about things like remote patient monitoring. RPM is not incentivized today, so you’re essentially giving it away. But if you’re giving it away in this mode,l then it matters, because it drives outcomes.”
 
The Dallas-based Elara Caring is one of the largest home health, home care and hospice providers in the country, with about 200 locations across 17 states.
 
The HHVBP model has given Elara Caring insights into what is working and what isn’t working at different locations.
 
For instance, the midpoint check-in has reinforced the need for predictive tools.
 
“Otherwise, we’re always just looking backward,” Mohan said. “So, we built an in-house, custom predictive tool that our branches are able to use and see on a real-time basis what they’re good at and what they need to improve on. I continue to be impressed at how this resonates culturally with people. If you give them the right tools, they can make an impact. We’re seeing that.”
 
On the flip side, the early results have shown that reducing hospitalizations will be a “never-ending challenge.”
 
For patient satisfaction and OASIS scores, the simplified strategy is to see where improvements need to be made and to stay on top of them. For clinically-driven results, it’s a tricker task.

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