CMS has issued a document that discusses the association of the QAPI program and improvement in Home Health Value-Based Purchasing model outcomes. Your QAPI program is a Condition of Participation, and it includes collecting and submitting data, analyzing reports, identifying measures for improvement, and development and implementation of quality improvement plans as a result of what you have decided needs improvement. 

When we look at the Home Health Value-Based Purchasing model, there will be outcome measures calculated. Five are OASIS, two are claims data that will come from acute care hospitalization and emergency department calculations, and five are from HHCAHPS which is patient surveys bringing us to twelve total outcome measures. 

These reports will start being issued to agencies in July 2023. The IPR (Interim Performance Reports) are issued reports that will show where you stand as an agency in the calculation of the Total Performance Score as compared to other agencies in the nation for Value-Based Purchasing.  That will include two cohorts, a large cohort and a small cohort. The large cohort is all agencies that are large enough to be required to participate in HHCAHPS. The small cohort will be the agencies that see less than 60 patients a year and are not required to participate in HHCAHPS.  These Interim Performance Reports are a data set that allows you the opportunity to not only work on your QAPI program but to be able to select measures that are related to Value-Based Purchasing. 

Clinical Consulting Services



On those reports, you will see those measure calculations and the scoring comparing you to other agencies within your cohort throughout the nation. You will be able to select measures that you are underperforming in, develop an improvement plan if necessary, and implement. Not only will you be participating in meeting the Condition of Participation in developing, implementing, and participating in the QAPI program, but you will be improving outcome measures for Value-Based Purchasing. 

It is also particularly important to note that many of the Value-Based Purchasing measures are also included in the star rating calculations being publicly reported on the Care Compare website. Specifically, all of the HHCAHPS measures are used in the CAHPS Star Rating and the Care Compare public viewing of your HHCAHPS outcomes, with the only exception to that being Willing to Recommend not being used in the Star Rating calculation even though it is used in Value-Based Purchasing. 

While Value-Based Purchasing is brand new to most of you, know that this is just going to be one more thing you must monitor. Know that you can make it a part of your QAPI program and it will not create a massive amount of additional work to oversee the outcome measures associated with the Value-Based Purchasing program. 

If you need assistance with Home Health Value-Based Purchasing or your QAPI program, don’t hesitate to let us know. 

Subscribe now to have our weekly Monday Minute with Melinda sent directly to your inbox. Click here to subscribe!