The expanded HHVBP Model began on January 1, 2022, with CY 2022 being the pre-implementation year, and includes Medicare-certified HHAs in all 50 states, District of Columbia, and the U.S. territories.
During 2022, CMS is providing HHAs with resources and training to allow agencies time to prepare and learn about the expectations and requirements of the expanded HHVBP Model without risk to payments. The first full performance year for the expanded HHVBP Model is CY 2023, beginning 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.
In the expanded model, “cohorts” are determined based on each HHA’s unique HHCAHPS survey-eligible beneficiary count in the calendar year prior to the performance year. HHAs are assigned to either a nationwide larger-volume cohort or nationwide smaller-volume cohort. This approach groups HHAs that are of similar size and are more likely to receive scores on the same set of measures for purposes of setting benchmarks and achievement thresholds and determining payment adjustments.
Data from OASIS, HHCAHPS, and claims-based measures are used to calculate HHAs’ Total Performance Score in a performance year, which is a numeric score awarded to each HHA based on the weighted sum of the performance scores for each applicable measure.