In 2025, significant changes are coming to the Home Health Value-Based Purchasing (HHVBP) model. These changes are designed to make the program better at evaluating and rewarding high-quality care in home health services.
It is important to understand that while these changes will not officially start until 2025, their baseline year is 2023, the current year. Home health agencies should familiarize themselves with these changes well in advance to ensure accuracy and achieve strong HHVBP performance scores once they become effective in 2025.
- Replacement and Removal of Certain Measures
The proposed changes to the HHVBP model involve replacing five existing measures with three new ones. One of the measures being replaced is the “Discharge to Community” measure, which is currently based on OASIS data. It will be substituted with a “Discharge to Community Post-Acute Care” measure that uses claims data. This new measure will assess the number of patients who, after leaving home health, do not need to go to the hospital or do not pass away within 31 days of returning to the community. Please note that there will be exceptions for specific cases, which can be reviewed in more detail here.
- Introduction of a new measure: Potentially Preventable Hospitalization (PPH)
The Value-Based Purchasing model’s next update will introduce the Home Health Within-Stay Potentially Preventable Hospitalization (PPH) measure. This measure has already replaced the Acute Care Hospitalization and Emergency Department measures in the Home Health Quality Reporting Program, and now it will also replace them in the value-based purchasing model. The goal of this new measure is to evaluate and reduce potentially preventable hospitalizations and observation stays while patients receive home health care. For more details on this change, click here.
- Replacement of the Total Normalized Composite Change in Mobility and Change in Self-Care measures
Lastly, there is a consolidation of measures where the Total Normalized Composite Change in Mobility and Change in Self-Care measures will be replaced by a single Discharge Function Score. This new score relies on GG items rather than M1800 items, streamlining the assessment process and offering a more comprehensive evaluation of a patient’s abilities at discharge. This change in regulations marked the first steps towards the replacement of M1800 items with GG items.
An ‘estimated’ Discharge Function Score is generated from the initial assessment of the patient at the Start of Care or Resumption of Care. Once the Discharge OASIS is submitted, the responses there are then compared to the estimated Discharge Function Score, and the final measure is determined based on whether your actual discharge responses match with or exceed the initial estimated Discharge Function Score.
Improving GG Item Responses
It is crucial to note that the Discharge Functional Score, determined by GG items, will significantly impact your Total Performance Score in value-based purchasing, accounting for 20% of it.
To enhance your agency’s understanding and utilization of GG items, begin by assessing your clinicians’ familiarity with GG items and consider additional training, if required, to ensure accurate completion of this section in the OASIS. Additionally, make sure that your QA staff also have a strong understanding and can offer the needed assistance to review the accuracy of GG item responses. These efforts will help maintain accuracy in your overall OASIS documentation and improve your agency’s performance in the Home Health Value-Based Purchasing (HHVBP) program.