Home Health & Hospice Week

Age, caregiver status, cognitive function are just a few of the risk factor components.

With Expanded Home Health Value-Based Purchasing hitting in less than 90 days, every scrap of VBP information may help.

Check out a fresh batch of VBP Frequently Asked Questions from the Centers for Medicare & Medicaid Services, including the following FAQ looking to head off a common criticism of the program.

Question: “How do the Total Normalized Composite (TNC) Measures consider individuals who may not have goals for improvement?” a home health agency asks in Q3017.

Answer: “The risk adjustment methodology for the [TNC] measures is designed to take into account instances where the goal of home health care is to maintain the patient’s current condition or to prevent or slow further deterioration of the patient’s condition by including risk factors for a wide variety of beneficiary-level characteristics,” CMS assures in the new FAQ. Those characteristics include “age, risk for hospitalization, living arrangements and caregivers available, pain, cognitive function, baseline functional status, and others,” CMS lists.

For instance: “A beneficiary with impaired cognition may not be expected to improve in self-care as much as a beneficiary without cognitive impairment,” CMS explains. “In effect, the self-care change score could shift up slightly for a beneficiary with impaired cognition relative to a beneficiary without cognitive impairment to account for the difference in expectations.”

For more details, HHAs can reference the HHVBP Model Composite Measure Calculation Steps and HHVBP Model Technical Specifications Composite Outcome Measures documents on the Expanded HH VBP webpage, CMS suggests. Links to them are under the “Total Performance Score & Payment Adjustment” section at https://innovation. cms.gov/innovation-models/expanded-home-health-value-based-purchasing-model.

Note: The FAQs, including the new ones released Sept. 30, are at https://innovation.cms.gov/media/document/hhvbp-exp-faqs.