How Home Health Providers Can Win The Hhbvp Competition

Providers are in the middle of a Home Health Value-Based Purchasing (HHVBP) Model payment year. This heightens the urgency for home health leaders to position their organization for optimal performance under this reimbursement framework.

Home health providers can set themselves up for success by prioritizing Outcome and Assessment Information Set (OASIS) excellence and data-informed care management.

In 2021, the U.S. Centers for Medicare & Medicaid Services (CMS) expanded HHVBP nationwide. Prior to the expansion, the model had been active in nine demonstration states since 2016.

Under HHVBP, home health providers are rewarded or penalized based on a variety of performance measures for a maximum upward or downward Medicare fee-for-service payment adjustment of 5%.

For 2025, the quality measures include three OASIS-based, two claims-based and five Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey-based measures.

One of the ways providers can set themselves up to see success under HHVBP is through OASIS competence, according to Cindy Campbell, senior director of advisory services at Wellsky.

“We need to build and work on OASIS competence in terms of assessment, process and technique,” she said during a recent WellSky webinar presentation.

Overland Park, Kansas-based WellSky utilizes software and analytics to help providers across the continuum achieve better outcomes at lower costs.

Providers must also prioritize risk and data-informed care management in order to improve and reduce re-hospitalization rates. These are critical measures that impact HHVBP performance.

“We’re able to better capture and gain risk-informed care management, [which helps] you to design a plan of care for a unique human being based on their unique risk profile,” she said. “What did their assessment show us? We need to teach our staff … to use clinical tools to design a best practice care plan for comorbid sick people in home health care.”

Under HHVBP, patient satisfaction also holds a lot of weight. Providers that are able to master patient satisfaction may see this reflected in their HHCAHPS survey responses.

“We really want to make sure that our patients are prepared to receive an HHCAHPS survey,” Campbell said. “Do they know one will be coming and what to expect? Have we lifted up patient-centered goals in our scripting in the home? Are we then also training the agency about what to do if we ever have a complaint? These are fundamental practices that are so important.”

Ultimately, providers should keep in mind that HHVBP is a national competition.

“HHVBP is a competition,” Campbell said. “If you look across the board at performance over time, understand one thing. From the 25th percentile all the way up to the 99th, quarter by quarter, people are getting better. Total performance scores are getting better. CMS did design the perfect mousetrap here.”

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