Today we’re taking a moment to revisit some of the key details included in the 2026 Home Health Final Rule.
One of the most significant areas of change is the Value-Based Purchasing Model, which will see important updates beginning January 1. The model will undergo notable changes, including the removal of three of the five HHCAHPS-related measures. Only two will remain due to the broader updates being made to HHCAHPS. We’ll cover those specific HHCAHPS changes in a future Monday Minute, as they will be implemented April 2026.
With the elimination of those three HHCAHPS items from Value-Based Purchasing, 18% of the current Total Performance Score is removed. Because of this, the program required a recalibration of its components and an adjustment to how the percentage weights are allocated.
As a result, the OASIS portion of the Value-Based Purchasing calculation will now account for 40% of the Total Performance Score. This update also includes the introduction of three new items in bathing, dressing the upper body, and dressing the lower body, derived from the OASIS 1800 series.
For the OASIS portion, the measures will now include the dyspnea question, oral medication management, the three newly added 1800-series items mentioned earlier, and the Discharge Function Score drawn from the GG items. Altogether, these components will make up 40% of the total score.
The next update to the Value-Based Purchasing Model is the addition of the Medicare Spending Per Beneficiary Measure. This will be incorporated into the existing Claims-Based Measures, joining the two already in place, the PPH Hospitalization Measure and the Discharge to Community Post-Acute Care Measure.
Together, those three measures will account for another 40% of your Total Performance Score. The remaining 20% will come from the two HHCAHPS items that remain: the Overall Rating of the Agency and the Willingness to Recommend. With this restructuring, Dyspnea and Oral Medication Management now carry greater weight, the Discharge Function Score has been slightly reduced, and the three newly added 1800-series items help balance out the distribution.
It’s important to recognize that the 40% tied to OASIS reflects an area where you have meaningful influence through staff education, strong QA practices, and ensuring accurate completion of the assessment. In contrast, the HHCAHPS portion offers less control, as it relies on patient feedback. The Claims-Based Measures also present challenges, particularly the PPH Hospitalization Measure and the Discharge to Community Post-Acute Care Measure, the latter of which tracks outcomes up to 31 days after the patient has transitioned out of your care.
The Medicare Spending Per Beneficiary figure remains something of a wildcard. It has been tracked since 2018, and you can view your results on the Care Compare site. If your spending value is below 1.0, it indicates you are performing well in comparison to the national average.
They also emphasized that the Claims-Based Measures apply only to traditional Medicare and are calculated using two years of data. This means that in 2026, the PPH, Discharge to Community Post-Acute Care, and Medicare Spending Per Beneficiary measures will all be based on 2025–2026 data. At present, the PPH and Discharge to Community measures for 2025 use data from 2024 and 2025. All three claims-based measures follow this two-year structure and rely exclusively on traditional Medicare patient data.
Finally, the October 2025 Interim Reports for Value-Based Purchasing have now been released. Be sure to review them to understand your standing with the current 2025 measures. For the OASIS portion, you will now have six months of data, and for the claims-based and HHCAHPS components, three months of results are available. The annual Final Report, which will include adjustments based on 2024 data and determine your payment impact for 2026, is expected to be released at any time.
If you need support assessing your current standing in the Value-Based Purchasing Model, HPS is here and ready to help! Please feel free to reach out to us.
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