Posted July 19, 2023
McKnight’s Home Care
By: Adam Healy
Attention home health agencies: The first official round of Interim Performance Reports (IPR), which will determine agencies’ future Medicare rates under the Home Health Value-Based Purchasing (HHVBP) Model, is slated to be released by the end of July.
As the IPR approaches, a panel of experts at the National Association for Home Care & Hospice (NAHC) Financial Management Conference suggested that providers monitor and refine their scores to get the best results and, therefore, the best rates.
“What you can’t afford to do is not be better than the prior year,” offered panelist M. Aaron Little, managing director of FORVIS. Continual improvement, he said, will be key to improving agencies’ Total Performance Score (TPS).
The HHVBP model, which expanded nationwide in January, measures providers based on their own performance as well as the average performance of other providers. The purpose of the new model, according to the Centers for Medicare & Medicaid Services, is to encourage home health providers to “focus on patient outcome and functional status, utilization, and patient experience.”
The IPR will use Outcome and Assessment Information Set (OASIS) data, claims data, and Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) results to determine each agency’s score. Agencies will then receive a TPS based on four categories: their overall performance; their improvement threshold, or amount they’ve improved compared to the year prior; their achievement threshold, or their score compared to other providers; and the benchmark, or their score compared to the best-performing providers.
CMS expects home health services to receive an overall increase in Medicare rate payments, but it will be dispersed among the best-performing providers, said the panelists.
The best-achieving agencies will receive a rate increase up to 5%, while the worst performers will have their rates cut up to 5%. To increase one’s TPS, said Oneika Griffin Webb, chief quality officer of QAPI Consulting, agencies should run internal reports frequently — at least monthly — to identify quality measures that can be raised. Data like this can be used to demonstrate an agency’s ability to influence quality patient outcomes.
“You can’t wait a quarter. You’re going to miss an opportunity,” she said in the panel discussion. “Even quick action items make a difference.”
Jon Higginbotham, vice president of business development at Homecare Homebase, emphasized the importance of HHCAHPS surveys. These surveys are often overlooked by both providers and patients; Higginbotham said that the national HHCAHPS response rate is only 24%. A bad survey response can hurt one’s TPS, but encouraging patients to review their quality of care, and using innovative techniques to garner more responses can lessen the impact of one bad survey.
The biggest TPS difference-maker, though, is an agency’s rate of acute care hospitalization claims, which will influence over 25% of the IPR’s scoring. While it is important to keep this number low, providers “also can’t afford to only focus on one or two measures at the expense of others,” Little added.
Each quarter, two IPRs will be released. The first is a preliminary report, and agencies will be given 15 calendar days to dispute any scores before the final IPR comes out about two months after the preliminary report. Each quarterly final IPR will be made public on Care Compare, according to the panel, allowing all patients and providers to see every agency’s results.
About Corridor
For over 30 years, Corridor has partnered with home health and hospice providers, delivering powerful solutions to support the unique challenges of caring for patients in the home. Our team of operations executives, clinicians, and nationally renowned industry experts have run provider organizations and resolved the same challenges you face. Contact us today to learn how we can help you.
To receive the most important industry updates, insights and news impacting home health and hospice, please make sure to sign up for our weekly newsletter.
