With the nationwide expansion of the Home Health Value-Based Purchasing Model (HHVBP) just months away, providers are actively working to sift through the regulatory change and its expected impact on the future of the home healthcare industry. Driven by the Centers for Medicare and Medicaid Services (CMS) efforts to improve home health agency (HHA) quality of care beneficiaries through payment incentives, the expanded HHVBP Model requires HHAs to compete on a set of quality measures related to the care that they provide.
According to CMS, under the expanded HHVBP Model, HHAs will receive adjustments to their Medicare fee-for-service payments based on their performance against a set of quality measures, relative to their peers’ performance. This means that performance on these quality measures in a specified year (performance year) will impact payment adjustments in a later year (payment year).
Set to be implemented nationwide on January 1, 2023, as the first full performance year, HHVBP will measure Outcome and Assessment Information Set (OASIS)-based, claims-based, and Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey-based measure data. Information from the 2023 performance year will then be used to calculate an HHA’s Total Performance Score (TPS) and their payment adjustment amount for the first payment year in 2025. Participation in the expanded HHVBP Model is mandatory for all Medicare-certified HHAs with a CMS Certification number in the 50 States, District of Columbia, and the U.S. territories. This includes home health agencies that are Medicare certified and receive payment from CMS for home healthcare services.
The countdown to the fast-approaching implementation date means that now is the time for participants to prepare for the model. For HHAs, the key to this preparation rests in their ability to improve their quality measures.
How to Improve Quality Measures Related to ED Utilization, Readmissions, and Post-Discharge Follow-Up
Bamboo Health can help HHAs succeed and adhere to the some of the new HHVBP measures with our real-time care intelligence solution, which provides ADT e-notifications to care providers in the moments that matter most. Bamboo Health’s Real-Time Care Intelligence™ helps HHAs scale how they manage patient populations, leading to better awareness and more complete care.
If a patient is admitted to a hospital, ED, or post-acute (I.e., skilled nursing facility, long-term acute care hospitals, inpatient rehabilitation facility, or hospice), providers for that patient will be notified immediately. Real-Time Care Intelligence not only helps to reduce ED admissions, but also improves post-discharge transitions and overall care coordination strategy.
Through what we call CareFlow™, the desired state of care coordination with the help of our solutions, helps HHA care teams foster continued patient engagement, the HHVBP model quality metrics. Here’s how Real-Time Care Intelligence can help your organization achieve success and compliance with the new HHVBP model:
1. Our solution helps your coordination upon discharge from HHA services to community services.
2. Your providers can utilize Pings to intervene at the ED to prevent IP admission and identify MVPs that may need different care to reduce the likelihood of readmission.
3. Our real-time notifications create the opportunity to show great improvement on HHCAHPS scores by bettering overall communication and coordination. Pings can allow HHA teams to be more proactive, quick, and informed with their outreach – creating better partnerships with health systems and improving continuity of care.
A home health, palliative, and hospice organization earned over $400,000 in revenue in just 5 months of using Pings to actively follow up with patients post-discharge.
Ahead of the January 1, 2023, deadline, Real-Time Care Intelligence can play a vital role in helping home health model participants be aware of moments that matter such as ED presentations as they occur, reduce admissions, and improve care coordination overall – a critical aspect for improving quality measures and enabling success under the expanded HHVBP Model.
“We care for elderly, frail, and homebound patients via house calls. Locating these patients through Pings, and having the opportunity to coordinate care upon discharge, is critically important. Pings has increased the amount of information had on our patients tenfold, which allows us to identify and manage our high-utilizing patients.”VP of Visiting Physician Services, Visiting Nurse Association Health Group
If you’re interested in learning more about how Pings can help HHAs improve quality metrics, contact us to get started.