Home Health & Hospice Week

Nationwide adoption of the demonstration could be in the cards.

If you didn’t have time to dive into the 106-page report about Medicare’s Home Health Value-Based Purchasing demonstration, you may find a two-page highlights document handy.

The “Findings At A Glance” summary notes that for the HHVBP program’s first two years, “there was a reduction in total Medicare spending in HHVBP states during and 30 days after home health episodes of care as measured by the average spending per day among fee-for-service (FFS) beneficiaries receiving home health services.” The size of the reduction was 0.9 percent, or a $114 million savings in annual Medicare spending in 2016 and 2017, the Centers for Medicare & Medicaid Services notes in the summary.

The savings for hospitalizations was more pronounced — 3.9 percent in those years. That represents an $88 million reduction, CMS notes.

At the same time Medicare saw savings, quality of care saw “modest gains,” CMS notes.“Total Performance Scores were 7 percent higher among HHAs in HHVBP states than HHAs in non-HHVBP states in 2017,” the summary says.

“There is no doubt that HHVBP saves Medicare spending,” notes National Association for Home Care & Hospice President William Dombi.

But that savings won’t necessarily translate into a widespread adoption.“We have been consis­tently told by parties at CMS that no decisions or recommendations have yet to be made regarding the future of the HHVBP model,” Dombi tells Eli.“I translate to mean that they will be letting the demo run its course before offering anything about its future.”

Stay tuned: Savings and quality scores may be seeing more dramatic changes as the reim­bursement effects of the demo take effect.CMS began adjusting reimbursement rates up to 3 percent for HHAs in VBP states in 2018, and the percentage of adjustment increases annually until it tops out at 8 percent in 2022.

NAHC is hopeful CMS ultimately will adopt the program for all agencies.“We have supported Congress expanding the model for at least two years,” Dombi says.“We want Congress to do so in order to get the budget credit on it, to offset other changes that the Congressional Budget Office might consider as a coster” — in other words, as requiring additional funding.

Note: The summary is at https://innovation.cms.gov/Files/reports/hhvbp-secann-rpt-fg.pdf.