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[VBP] What you can expect from the expansion of Value-Based Purchasing

    Home health agencies received good news from the US Department of Health and Human Services (HHS) when the expansion of the Home Health Value-Based Purchasing (HHVBP) Model was signed off and announced last January 8.

    First implemented in 2016, the HHVBP Model has only been active in nine states: Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee.


    HHVBP by the numbers

    HHVBP was formed as part of the government’s initiative to shift away from volume-based reimbursement. The program rewards or penalizes home health providers based on their quality performance.

    Specifically, the goal of HHVBP is to see better post-acute care outcomes for Medicare beneficiaries and to let the Centers for Medicare & Medicaid Services (CMS) better identify which providers deliver high or low-quality patient care.

    Since its rollout, HHVBP prompted an average 4.6% improvement in the quality scores of home health agencies, as well as an average annual savings of $141 million to Medicare (according to CMS).

    Maximum value-based payment adjustment through the years:

    2018- 3%
    2019- 5%
    2020- 6%
    2021- 7%
    2022- 8%

    On top of these figures, agencies in HHVBP states have been able to significantly reduce the costly utilization of hospitals and skilled nursing facilities (SNFs). Unplanned acute care hospital expenditures decreased by $1.50 per day or 4.5%. Skilled nursing facility (SNF) expenditures fell by 4% per day, while emergency department expenditures increased by 5.9% per day.


    Expansion plans 

    More specific details are yet to be announced as to the extent of the planned HHVBP expansion. It is still unknown whether the expansion will be national or more incremental, gradually adding more states into the current list of nine.

    Moreover, it is also yet to be decided whether the expansion will be implemented through a standalone proposal or the annual rulemaking cycle.


    Avenues for Improvement

    With how the HHVBP model is currently structured, it seems unlikely for providers to reach the maximum payment incentive or penalty. Many feel like the structure is more drawn towards the center of the curve —it can be tricky to hit the full rewards or penalties.

    On the other hand, industry leaders acknowledge that those who use technology and documentation solutions to establish efficient tracking systems to reinforce their clinical operations are the ones who can benefit the most out of HHBVP. 

    It’s an opportune time to take advantage of solutions that can help you optimize other key functions so your in-house team can regain focus on patient care and your main business objectives.