Home Health Value Based Purchasing expansion update

The April 2022 Expanded Home Health Value Based Purchasing (HHVBP) Model newsletter is now available. Education materials will be located on the expanded model webpage and some items will be located in iQIES. Benchmark and achievement thresholds are expected to be posted in iQIES in mid-May. Providers should expect a guide, updated materials for two composite measures, podcasts and videos related to home health to be posted. A sample interim performance report and a final report will be available in iQIES with a webinar to be held in August to discuss the reports.  CMS encouraged providers to sign up for newsletters via the model’s webpage to know when these materials are available. Questions can be submitted to the Help Desk at  HHVBPquestions@lewin.com

How are baseline years used in the expanded HHVBP Model?

There are two baseline years used in the expanded HHVBP Model — the model baseline year and an HHA baseline year.

  1. The Model baseline year is the calendar year (CY) used for calculating the benchmarks and achievement thresholds for each quality measure for each of the two nationwide cohorts. For the CY 2023 performance year/CY 2025 payment year, CY 2019 will serve as the model baseline year for calculating the achievement thresholds and benchmarks for each cohort.
  2. The HHA baseline year is the CY in which CMS will compare an HHA’s performance score by measure during a performance year and calculate each HHA’s unique improvement threshold.

CMS uses an HHA’s Medicare certification date to determine the HHA baseline year as follows:

  • HHAs with date of Medicare certification prior to Jan. 1, 2019: The HHA’s baseline year is CY 2019 (Jan. 1, 2019 – Dec. 31, 2019).
  • HHAs with date of Medicare certification on or after Jan. 1, 2019: The HHA’s baseline year is the HHA’s first full CY of service beginning after the date of Medicare certification, except for HHAs certified on Jan. 1, 2019 – De. 31, 2019.
  • HHAs with a date of Medicare certification on Jan. 1, 2019, through Dec. 31, 2019: The HHA’s baseline year is CY 2021, and the first performance year is the first full CY (beginning with CY 2023) following the HHA’s baseline year.

An HHA must have sufficient data to establish the HHA baseline year for a particular quality measure. An HHA must meet the minimum threshold of data per measure per reporting period on five or more of the applicable measures in the baseline and performance years, as illustrated in Exhibit 1. A complete list of the expanded HHVBP Model measure set is available in the Expanded HHVBP Model Frequently Asked Questions.