Home Health & Hospice Week

Get more info on whether you’ll see a pay boost or penalty based on your performance.

Whether you’ve made much use of your July VBP Interim Performance Report or not, you’ll be getting an updated version in a matter of weeks.

Reminder: The Centers for Medicare & Medicaid Services issued home health agencies’ first Value-Based Purchasing IPRs on July 21, then issued corrected versions on Aug. 1 (see HHHW by AAPC, Vol. XXXII, No. 35). By the way, those corrected IPRs still show a “created” date of July 20, so no need to worry you have a report with incorrect info if it still has the original date, CMS says in its newest VBP Frequently Asked Question set. CMS issued the final version of those reports on Aug. 21, it confirms in the FAQs.

“In October 2023, the second quarterly Interim Performance Report (IPR) will be available to home health agencies (HHAs) via iQIES,” CMS says in the September VBP newsletter sent to providers on Sept. 22. “The quarterly IPRs provide HHAs with the cohort assignment, performance year measure data for the 12 most recent months, and interim Total Performance Score (TPS),” CMS reminds agencies.

Providers will note some differences between the July and October reports, CMS highlights. For one, “the performance data time periods for the October 2023 IPR will differ from those used for July 2023,” the agency explains. “The October 2023 IPR will report 12 months of data, ending June 30, 2023, for OASIS-based measures, and ending March 31, 2023, for both the claims-based measures and Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey-based measures.”

The July report included data through March 31, 2023 for OASIS-based measures and Dec. 31, 2022 for claims- and CAHPS-based measures, CMS points out.

And care points will now include both improvement and achievement points for claims- and CAHPS-based measures, CMS adds. Care points “indicate the higher of either the achievement points or improvement points for a quality measure,” the agency reviews. “For the July 2023 IPR, only achievement points for claims-based and HHCAHPS Survey-based measures were used to calculate care points, since improvement points were zero.”

How it works: “For the October 2023 IPR, care points will be calculated by comparing achievement and improvement points,” CMS says.

Get Your First Peek At These Improvement Points

Tip No. 1: You get improvement points only when the value in the “Your Performance Year Measure Value” column exceeds the value in the “Your HHA’s Improvement Threshold” column, CMS instructs. In other words, “an HHA will receive improvement points if the measure value is greater than the improvement threshold,” it details.

The October IPR will be the first report where improvement points are available for claims- and CAHPS-based measures because in the July report, “the data time periods, CY 2022, were the same for the HHA baseline year, and performance year,” CMS adds. “There was no opportunity for an HHA to demonstrate improvement.”

Tip No. 2: CAHPS-based measures are not included in the Total Performance Score (TPS) calculation for HHAs in the smaller-volume cohort, CMS explains. Agencies in the smaller-volume category are exempt from CAHPS requirements, the agency notes.

For more help understanding your IPR, access the IPR resources on the VBP webpage, including the July 27 webinar that provides an overview of the reports. Those resources are under the “Model Reports” section at www.cms.gov/priorities/ innovation/innovation-models/expanded-home-health-value-based-purchasing-model.

Other new VBP news includes:

• Medicare’s latest FAQ set includes 10 new questions and five updated ones, according to the 73-page document (see box, p. 271.)
• CMS issued a new educational tool on patient monitoring in its September VBP newsletter. “This month’s Strategies for Success highlights strategic practices related to monitoring for changes in patients’ clinical status,” CMS explains in the newsletter. “The briefing card … follows an SBAR (situation, background, assessment, and recommendation) format, leading to a recommendation on how an HHA can address opportunities for improvement,” it says.
• The nomination period for CMS’ Technical Expert Panel on VBP refinements closed on Sept. 27. VBP contractor Abt Associates “will convene a Technical Expert Panel to gain feedback during development and maintenance of the expanded HHVBP Model,” CMS says on its TEP webpage.

Timeline: The panel is expected to operate for “several years,” with its first introductory teleconference in October and first in-person meeting in November, according to the agency.