Get ready to compete on performance: 5 Tips for HHVBP preparedness

November 7, 2022
Categories: Home health
Reading Time: 3 minutes

By: Brandy Shifteh, RN, BHSA, MBA, Regulations Compliance Manager, MatrixCare

The Home Health Value-Based Purchasing (HHVBP) Model has been considered a success, resulting on average a 4.6% improvement in home health agency (HHA) performance and an annual savings to Medicare of about $141 million. Model assessment findings also demonstrated reductions in unplanned acute care hospitalizations and skilled nursing facility stays — which led the U.S. Secretary of Health and Human Services (HHS) to continue this reduction of Medicare spending and to improve quality of care by expanding the original HHVBP Model.

This expanded HHVBP Model began on January 1, 2022, with CY 2022 being the pre-implementation year, including Medicare-certified HHAs in all 50 states, District of Columbia, and the U.S. territories. The first full performance year for the expanded HHVBP Model begins January 1, 2023. CY 2025 will be the first payment year, with payment adjustment amounts upward or downward of 5%, which will be determined on CY 2023 performance.

With the first performance year fast approaching, HHAs must prepare by understanding the expansion, meeting requirements, and finding success along the way. Here are five tips for HHVBP preparedness:

1. Understand the HHVBP measures and their data sources

The HHAs that will be positioned for success with the expanded HHVBP Model performance will be HHAs that understand the model measures and are realigning their current Quality Assessment and Performance Improvement (QAPI) programs to focus on their identified skills gaps and areas of opportunity to improve clinical competence with OASIS assessments, focus on patient satisfaction, and continue to reduce hospitalization and urgent care utilization.

Of the 12 currently approved quality measures to be used in the expanded HHVBP Model, there are five OASIS-based measures, two Medicare FFS claims-based measures, and five HHCAHPS survey-based measures. All measures in the expanded model use data already submitted by HHAs to meet the requirements of the Home Health Quality Reporting Program (HHQRP) and the submission of claims, therefore there is no need for agencies to submit additional data to fulfill the requirements of the expanded model. Also, most of the current expanded HHVBP measures cross several CMS quality improvement initiatives, so it is important for HHAs to develop an understanding of the source and use of each measure.

2. Identify your baseline and know your skill gaps

HHAs should assess their performance to each HHVBP measure, identify any skill gaps, and determine any opportunities for improvement. The expanded model will use benchmarks, achievement thresholds, and improvement thresholds to assess achievement or improvement of performance on applicable quality measures. HHAs must demonstrate that they can deliver higher quality of care in every performance year.

3. Develop a targeted QAPI plan

It is important to develop a targeted QAPI plan that leverages the HHA’s baseline assessment to identify HHVBP quality measures that need improvement. It’s also important to review and update current policies and procedures where needed, and to set clear expectations for staff on all levels through adjustments to the agency’s key performance indicators.

4. Invest resources into education and training

Patient satisfaction, strong clinical skills, competence with OASIS assessment accuracy, and continued hospital and urgent care utilization reduction will be critical for success under the HHVBP Model. HHAs should be focusing ongoing education and training around these critical areas and taking advantage of free educational resources offered by CMS for both the expanded HHVBP Model and the new OASIS-E assessment instrument, which is effective January 1, 2023.

5. Leverage analytics

Analytics give HHAs the ability to pull data in real time for their QAPI programs so they can continually work on improving key outcomes. Our suite of powerful analytics tools includes MyAnalytics, MyScrubber and MyData — each providing unique insight and allowing data to be filtered by quality episode or admission dates, by office, by clinician, or by the VBP numerator or denominator.

With the right tools, HHAs can get a high-level overview of quality measures, visibility into OASIS measures, improved performance scores, and drill-down capabilities — ultimately helping agencies identify opportunities for improvement and achieve HHVBP success.

Go into the CY 2023 performance year with confidence. Request a demo today to see for yourself how MatrixCare can prepare your agency to compete on performance and succeed under HHVBP.

Brandy Shifteh
Brandy Shifteh

Brandy Shifteh, RN, BHSA, MBA, joined MatrixCare in April of 2018 as a Clinical Informatics Business Analyst, where she has been very involved in the development and enhancement of clinical analytics that supports scrubbing of OASIS assessment data, casemix/HIPPS scoring, clinical assessment reviews and coding. In April of 2019, she transitioned into a Regulations Compliance role, where she is responsible for monitoring regulations that impact home health, hospice and private duty home care, to help ensure our solutions support all existing and new regulations. She is very plugged into the regulatory community with relationships at both the state and federal level and serves as an active member on the National Government Services (NGS) Vendor Coalition group, where she provides input on MAC provider education and materials. Brandy is a Registered Nurse and comes to us with over 23 years of operations management experience in the home health, hospice and private duty home care sector, inclusive of accreditation/survey preparedness, compliance and clinical/quality improvement programming. She holds two undergraduate degrees; science and nursing and health services administration; and an MBA in computer information systems (CIS).

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