Three Actionable Strategies to Improve Your HHVBP Scores and Reimbursement

With the completion of the first performance year (2023) under Home Health Value-based Purchasing (HHVBP), understanding how your agency performed will help you improve your future performance. We spoke to leading home health agencies to find out what they learned from the first year, but now it’s vital to take those lessons and learn how to understand your performance and utilize that data (with the help of home health software) to improve your performance scores.

1. How to Understand Your HHVBP Performance

There are two primary ways to understand your performance. The first is the Annual Performance Report available beginning August 2024, which will give you a broader picture of how your agency did and what you can expect for that payment adjustment.

The second—and more immediately relevant to your agency today—is the Interim Performance Report (IPR). IPRs are released on a quarterly schedule, with the first release in July 2023. This report provides a look at the current benchmark, what the thresholds are for the achievement level, and your current performance so you know where you need to improve. 

CMS provided guidance on how to access your IPR here.

Your IPR will look something like this:

Your Care Points are going to be the higher of either your Achievement Threshold or Improvement Threshold points. If you score a zero, you’ll get zero of those points. The higher your score, the better your ranking. The Percentile Ranking column gives you a quick snapshot of where you are scoring for each category as it relates to the benchmark. This is a good way to immediately get a sense of what your agency needs to work on. 

In this example IPR, the agency in question has two measures that are in the bottom 25th percentile: Discharged to Community and Specific Care Issues. In this case, the agency would want to work on those two items the most. On the other hand, there are two measures that are in the 50th to 74th percentile ranking, Improvement in Dyspnea and Emergency Department Use Without Hospitalization, indicating that the agency is performing well in these areas. 

But with so many measures to consider, how do you know what to prioritize for improvement?

2. How to Prioritize HHVBP Improvement Measures

Looking at this second table, you can see the Measure Weight column in the far right. Discharged to Community clearly needs improvement at its current <25th percentile ranking, but it only carries a measure weight of 5.83. Compare that to Acute Care Hospitalizations, which could also use some work as it’s currently in the 25th to 49th percentile ranking, but carries a much higher measure weight of 26.25. The ceiling on that item—or even some of the other items in the OASIS category that score 8.75—are higher, so it’s important to look at the potential upside of improving each measure. 

This is not to say that you shouldn’t be focusing on struggling measures just because they aren’t worth as much—your duty is to provide the best care to your patients. But it is important to consider the entire context when deciding how to best use your limited time and resources, especially when there are some clever ways that data can be utilized to efficiently improve several measures at once.

3. How to Utilize Your Interim Performance Report (IPR) Data For HHVBP Success

After you got your first IPR in July 2023, the next two were available in October 2023 and January 2024. It’s crucial to review these IPRs to determine the lowest performing measures and percentile ranking and then analyze VBP-specific data over the past 12 months to identify any negative (or positive!) trends in your performance scores.

Next, determine the impact of your efforts to improve your scores. As we established before, the Acute Care Hospitalizations measure carries a much higher weight than the Discharged to Community measure. But working on one metric may yield improvements to other metrics—for example, by working to improve Acute Care Hospitalizations, you may unlock a secondary effect that actually increases the amount of patients Discharged to Community, even if you don’t have a direct initiative focused on that measure.

As another example, consider how improvement in Management of Oral Medications may lead to decreased hospitalizations for medication-related issues and increased HHCAHPS responses in the Specific Care Issues category. Examining the data to find these connections can help you utilize your resources more efficiently while raising the overall quality of care.

Next, let’s look at overall IPR trends from the first two quarters of data. Initial IPR trends from July 2023 to October 2023 show some great news—everyone has been improving! A score of 11.898 that would have you in the 25th percentile has now been raised to 14.648. Each quartile has improved across the board, but you’ll notice that the higher percentile score you achieve, the more the rate of improvement declines. 

Remember to check your January IPR report and see where you fall against these first two quarters. Agencies in the 50th percentile are likely to see little to no payment adjustment while agencies in the above percentiles are more likely to see a positive payment adjustment, and those in the 25th percentile are likely to see a negative payment adjustment. You can use these learnings to see if your initial improvement investments have been paying dividends, or if you need to make further adjustments.

How MedBridge Can Help You Prepare for HHVBP in 2025 and Beyond

Whichever HHVBP improvement initiative you’re focusing on, MedBridge can help you tackle your biggest challenges.

Reduce Hospitalizations and Boost HHCAHPS scores

Our Clinical Procedure Manual supports excellence at the point of care with just-in-time training, accessible everywhere nurses go—even a patient’s driveway.

Get Nurses Trained and in the Field Faster

Our Skills and Competency Manager combines an online skills assessment checklist and engaging, evidence-based skills training to help improve quality of care and patient satisfaction, meet regulatory requirements, and reduce risk.

Improve OASIS Accuracy

Superior OASIS training and education yields superior results! Establish a strong foundation for accurate OASIS data collection and continually refresh knowledge with integrated training, assigning, and management tools.

Free Recorded HHVBP Webinar

Want a deep dive into the latest trends, HHVBP improvement strategies, and a Q&A? Check out our recent webinar on the subject, Home Health Value-Based Purchasing: Lessons Learned From the First Performance Year.