Final Evaluation Report of the HHVBP Original Model (2016-2021)

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

The original Home Health Value‐Based Purchasing (HHVBP) Model provided financial incentives to home health agencies for quality improvement based on their performance relative to other agencies in their state. The HHVBP Model aimed to improve the quality and efficiency of home health services to Medicare beneficiaries. Nine states were randomly selected to participate in the original HHVBP Model (calendar years 2016‐2021). Agencies in these states received performance scores for individual measures of quality of care that were combined into a Total Performance Score (TPS) to determine their payment adjustment relative to other agencies within their state. CMS first adjusted Medicare payments by up to ±3% in 2018, using agencies’ 2016 TPS. Payment adjustments increased each year, peaking at up to ±7% in 2021, the last year of the original HHVBP Model prior to the nationwide expansion of the model in January 2023. This document summarizes the impact observed in 2016 through 2021, the complete six years of the original model, including all four payment adjustment years.

All Medicare‐certified home health agencies providing services in the following states were included in the original model: Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, and Washington. In 2021, the last year of the original model, there were approximately 1,952 home health agencies in the nine HHVBP states, representing 19% of all agencies, which provided 2.1 million home health episodes to over 751,000 Medicare beneficiaries.