Home Health & Hospice Week

Plus: Keep your iQIES account active or face delays.

Whether you’ve been working hard on VBP or pretending it doesn’t exist, you’re just three months away from knowing how your Home Health Value-Based Purchasing scores are going to affect your payment rates in 2025.

The Centers for Medicare & Medicaid Services will issue preliminary Annual Performance Reports in August for the first APRs scheduled for October, CMS’ Marcie O’Reilly reminded agencies in the May 22 Home Health Open Door Forum. The APR “will include the [Total Performance Score] total score for calendar year ‘23 and the associated payment adjustment that will be applied to all Medicare fee-for-service claims submitted for home health services provided in 2025,” O’Reilly reviewed.

“And the information on the APR will be publicly reported starting in January,” O’Reilly told attendees.

Remember: As part of the APR preview process, HHAs will have the ability to submit a recalculation request; then a reconsideration request; and then an Administrator review request, CMS details in the VBP Frequently Asked Questions last updated in December.

In August, CMS plans to “provide a webinar that will walk you through the APR and the plans for public reporting,” O’Reilly revealed.

Meanwhile, HHAs can get a look at their next Interim Performance Report the week of June 10, O’Reilly said. “We encourage the many HHAs that have not been accessing their IPRs to do so, and for all HHAs to access each quarterly report as soon as they are released,” she stressed.

Potential problem: CMS is implementing a new inactive user policy for iQIES, the system that houses the IPRs, APRs, and other reports. It will kick off providers who haven’t used it in 60 days, O’Reilly highlighted.

“To align with CMS security policies, iQIES will begin implementing an inactive user policy this month,” CMS says in a May 16 email to providers. “This will allow CMS to continue to ensure that our system is safe and secure.”

How it will work: “System audits will be conducted on a regular basis to identify users who have not logged in to the iQIES system in more than 60 days. Inactive users will receive an email indicating that they will need to log in to iQIES to keep their iQIES user role(s) and account active. If inactive users do not log in to the iQIES system, their iQIES role(s) will be revoked and they will not be able to access the system,” CMS details in the message.

The good news is that “if your iQIES role access is revoked, your Health Care Quality Information Systems (HCQIS) Access Roles and Profile (HARP) credentials will continue to remain active. All your HARP account information will not be affected and will be accessible once your iQIES user role(s) are restored,” CMS says.

The bad news is that “to restore your account, you will need to log into iQIES and re-request your user role(s),” CMS instructs.

Avoid the hassle: “Please log in to iQIES regularly to avoid having your iQIES roles revoked and any potential delays that may occur if you are required to re-request your roles within iQIES,” CMS urges.

Other VBP issues addressed in the forum include:

• Training for new VBP measures. Effective Jan. 1, CMS will replace the two Total Normalized Composite Measures (for Self-Care and Mobility) with the Discharge Function Score (DC Function) measure; replace the OASIS-based Discharge to Community (DTC) measure with the claims-based Discharge to Community-Post Acute Care (DTC-PAC) Measure for HHAs; and replace the claims-based Acute Care Hospitalization (ACH) During the First 60 Days of Home Health Use and the Emergency Department Use without Hospitalization During the First 60 Days of Home Health measures with the claims-based Potentially Preventable Hospitalization (PPH) measure (see more details in HHHW by AAPC, Vol. XXXII, No. 39-40).

CMS plans to provide on-demand web-based training on the measure changes in August, O’Reilly told agencies in the forum. VBP reports will have new tabs that address the updated measures, she explained.

• Quarterly newsletters. It’s not your imagination, you have been receiving VBP news less often than before. CMS has switched its monthly VBP newsletters to quarterly ones, O’Reilly reminded providers. And the next set of VBP FAQs should be out by the end of the month, she added.

Note: VBP details are at www.cms.gov/priorities/innovation/innovation-models/expanded-home-health-value-based-purchasing-model.