‘fanatic, Tenacious’ Home Health Providers Poised To Succeed Under Hhvbp

Home health providers aiming to achieve success under the Home Health Value-Based Purchasing (HHVBP) Model must implement clinical strategies that will help improve their scores.

Detail-oriented providers who commit to daily and weekly data reviews can see their efforts rewarded with notable bonuses, according to Chris Attaya, vice president of product strategy at data analytics company Strategic Healthcare Programs.

The U.S. Centers for Medicare & Medicaid Services (CMS) expanded HHVBP across the country in 2021. The model had been an active demonstration in nine states since 2016, prior to this expansion.

Under the model, home health providers are incentivized or penalized according to a number of performance measures for a maximum upward or downward Medicare fee-for-service payment adjustment of 5%. Coming into 2025, HHVBP went down from 12 measures to 10.

Avoiding preventable hospitalizations is still one of the best clinical strategies for improving performance scores under HHVBP, according to Attaya.

“You want to, of course, keep them out of the [emergency department] (ED), so that we can avoid them being put into an observation bed,” he said during a presentation in July at the National Alliance for Care at Home Financial Summit.

Also important is understanding the patient’s risks and addressing them in the care plan as part of episode management.

“It’s everybody’s job — from the front desk to the clinician to the aide — to communicate when there’s something going on to make sure the team knows, to help keep them at home,” Attaya said.

Hospitalization retrospectives are another strategic tool to ensure strong clinical outcomes.

“It’s really important because you’re really trying to dig down and determine what were the commonalities of the patients that were hospitalized,” Attaya said. “What were their diagnoses? Is there something in our care plans that we should be tweaking or updating? Is it something happening with one of my teams? Is it something happening with a couple of clinicians? Go back and look at the last 10 to 14 days.”

Attaya noted that providers can make hospitalization retrospectives part of the organization’s Quality Assurance and Performance Improvement (QAPI) programs.

Providers should also be utilizing hospitalization risk predictors, Attaya noted. Some EMR vendors offer this solution, Attaya noted.

The discharge process and OASIS competency, as well as improving Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores, should also be top priorities for providers when it comes to HHVBP.

Ultimately, the most detail-oriented providers are well-positioned to perform well under HHVBP.

“One of the agencies I talked with was getting a 5% bonus,” Attaya said. “They were tenacious about drilling into the details regularly. This is not like, ‘I’m going to do it once a quarter.’ You have to be fanatic and find out where the opportunity is, and where the problems are. Be tenacious and be intentional. Make sure you have regular weekly, daily reviews of high-risk patients. Build it into your episodic management plans. Look at the data of real-time outcomes.”

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