HHVBP in 2025: What Home Health Agencies Need to Know

The Centers for Medicare & Medicaid Services (CMS) has made significant changes to the HHVBP model for 2025, and they’re now in effect. These changes are designed to drive better patient outcomes, reduce costs, and encourage high-quality care. While these updates create opportunities for agencies to thrive, they also present challenges that require proper planning and adaptation. Agencies that stay informed, implement strategic changes, and invest in the right tools will be better positioned for success. Here’s what you need to know about the 2025 HHVBP updates and how to navigate them effectively.

Key Updates to the HHVBP Model

The 2025 HHVBP updates reflect a stronger emphasis on functional outcomes, patient satisfaction, and post-discharge success, with the goal of incentivizing better care and efficiency. Here’s an overview of the updates:

Functional outcomes assessed with GG items: Functional outcomes are now assessed using GG items, replacing some previous measures. GG items primarily evaluate patients’ self-care and mobility. Agencies must ensure that clinicians are well-trained in using GG items to capture accurate data and meet performance expectations.

New metrics for 2025: The Discharge Function Score (DFS) and Potentially Preventable Hospitalizations (PPH) metrics are important new additions. DFS measures the improvement in a patient’s independence from admission to discharge, while PPH tracks hospitalizations that could have been avoided with proper care. These changes are intended to encourage agencies to focus on proactive patient monitoring and preventive strategies.

Changes to risk-adjusted measures: Adjustments to claims-based measures now allow for a broader range of factors, including patient complexity and social determinants of health. Agencies must adopt strategies to address these disparities to achieve competitive performance scores.

Discharge to Community (DTC): Updates to the DTC calculation include additional factors that provide a more comprehensive picture of patient outcomes post-care. This measure encourages agencies to prioritize long-term success by reducing rehospitalizations and emergency visits.

Why These Changes Matter

These updates emphasize the need for agencies to adopt a data-driven approach to care delivery. Performance metrics will be weighted more heavily on outcomes that reflect patient independence, satisfaction, and overall well-being. For instance, in 2025, an agency’s Total Performance Score (TPS) will be calculated as follows:

• OASIS-based measures: 35%
• Claims-based measures: 35%
• HHCAHPS survey-based measures: 30%

Strategies for Success Under HHVBP

To thrive in 2025 and beyond, agencies must focus on data-driven decision-making, clinical accuracy, and patient satisfaction. Here are some key strategies:

Leverage Data to Guide Decisions

In a value-based care model, data is a powerful tool. Use CMS’s iQIES reports to identify gaps in performance metrics like PPH or DFS. Real-time tracking systems can monitor patient progress and flag patients at risk for adverse events. Exception-based management allows agencies to identify patients or processes that deviate from expected norms in order to allocate resources more effectively.

Focus on OASIS Accuracy

Accurate OASIS assessments directly impact core performance metrics. Train clinicians to collect precise data during key touchpoints—Start of Care (SOC), Resumption of Care (ROC), and discharge. Provide high-quality training such as Medbridge’s comprehensive OASIS education and OASIS Boosters to ensure that clinicians are confident in assessments.

Elevate Patient Satisfaction

Patient experience plays a significant role in HHVBP scoring. To improve HHCAHPS scores, agencies should focus on creating good first impressions with patients, performing interdisciplinary customer service training, and seeking feedback from patients.

Tailoring Training and Education

Proper staff training is essential for success under HHVBP. Agencies can boost performance by focusing on these strategies:

• Implement a strong onboarding program that includes preceptor programs and tailored training tracks focused on the metrics that matter most under HHVBP, such as functional improvement, accurate documentation, and claims-based outcomes. Medbridge Skills helps agencies assess clinician competency across key skills aligned with HHVBP metrics.
• Provide ongoing competency-based training on key areas like OASIS-E1 accuracy, chronic condition management, and patient satisfaction. Tools like the Medbridge HHVBP Solution offer targeted modules to standardize practices across teams.

Leveraging Technology for Competitive Advantage

For agencies striving to succeed under HHVBP, digital tools streamline workflows, enhance clinician training, and improve patient outcomes—key drivers of success in value-based care. Medbridge offers innovative solutions designed to address these needs, equipping agencies with the tools to stay agile and competitive.

Clinical Procedure Manual provides clinicians with a single, reliable source of truth to ensure consistent and accurate care delivery. With tablet-ready, easily searchable procedures approved by an expert review board, the Clinical Procedure Manual helps empower clinicians at the point of care and reduce variability in clinical practices through standardized protocols.

Medbridge Skills enables real-time tracking of skill gaps and progress, ensuring clinicians are prepared to meet performance standards.

Our Patient Engagement Solution keeps patients activated, inspired, and on track between home visits with easy-to-assign exercises and educational modules.

Looking Ahead

In 2025 and beyond, agencies that embrace data-driven strategies, invest in clinician training, and leverage technology will be best equipped to succeed with HHVBP. Staying informed and agile is key to navigating these latest changes and delivering exceptional care.