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Understanding the Interim Performance Reports for HHVBP

    Last July 21, the Centers for Medicare & Medicaid Services (CMS) released the first official round of Interim Performance Reports (IPR) in the iQIES system. These reports contain data that will determine agencies’ future Medicare rates under the Home Health Value-Based Purchasing (HHVBP) Model. They feature detailed calculations that compare each agency’s performance against others in the same cohort, and present computed outcome measure results.

    Thoroughly examining the IPRs is essential for agencies to identify challenges in the Value-Based Purchasing model and strategically focus on areas that need improvement.

    IPR vs. PIPR

    The Interim Performance Reports (IPR) closely resemble the Pre-implementation Reports (PIPR) being examined. However, it is essential to note that IPRs are not the same as the PIPRs previously received through iQIES.

    The IPRs set themselves apart from the PIPRs because they incorporate the 2022 data as the official baseline year for achievement thresholds and benchmarks. In contrast, the PIPRs were based on 2019 benchmarks and thresholds as the 2022 data was not accessible at that time.

    Understanding the Contents of IPRs

    The IPRs comprise essential information that agencies need to comprehend thoroughly. These reports are released quarterly with two distinct types. The first one is a preliminary report that incorporates achievement thresholds and benchmarks from 2022, which serves as the baseline year for 2023. Understanding these thresholds and benchmarks is vital as they provide insights into how agencies perform compared to others in their cohort.

    The IPRs include the following:

    • An interim Total Performance Score (TPS) along with the individual measure performance scores.  This score is preliminary and subject to change based on overall performance throughout 2023. The final TPS, which determines agencies’ standing, will not be available until August 2024.
    • Scores corresponding to individual measures to support agencies in understanding how each measure contributes to their interim TPS.
    • Improvement, Achievement, and Care Points reflecting an agency’s performance relative to the performance of other agencies in your cohort, including the achievement thresholds and benchmarks for that cohort
    • A Total Normalized Composite (TNC) Change Reference tab to assist agencies in understanding performance on the individual OASIS items included in the two TNC measures

    It is important to be aware that the IPRs encompass data from a 12-month rolling period. The OASIS data considers the first three months of 2023 and the preceding nine months of 2022. In contrast, the data for claims-based measures and Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) measures rely solely on the 12 months of 2022.

    Tips for Improving VBP Performance Using IPR

    • Frequent Internal Reporting: Run internal reports at least monthly to identify quality measures that can be improved. Utilize this data to showcase your agency’s ability to influence positive patient outcomes.
    • Utilize QA Team: Leverage your Quality Assurance (QA) team to focus on OASIS items and quality measures that require improvement. Ensure that your QA program supports re-educating clinicians to enhance their documentation for sustained documentation quality.
    • Pay attention to HHCAHPS Surveys: Don’t overlook the significance of HHCAHPS surveys because they determine your Total Performance Score (TPS). Encourage patients to provide feedback on the quality of care they received and employ innovative methods to increase survey responses, reducing the impact of a negative survey.
    • Balance Multiple Measures: While reducing acute care hospitalization claims is vital for a high TPS, avoid focusing solely on one or two measures at the expense of others. Strive for a balanced approach to improve performance across various quality measures.

    Further Guidance on IPRs

    Upon the arrival of the first preliminary report in the system, agencies have a 15-day window to request a recalculation if any inaccuracies in their figures are suspected. However, it is essential to provide evidence supporting the claim of incorrect information. The Value-Based Purchasing June newsletter contains detailed instructions, including links to the appropriate platform for submitting recalculation requests.

    Each quarterly final IPR will be made publicly available on Care Compare, enabling patients and providers to access and review the results of all agencies. CMS has also published a sample Interim Performance Report for agencies to reference.