The expansion of Value-Based Purchasing has now been applied across the nation, marking 2023 as its inaugural performance year. The most recent development involves the release of the first Interim Performance Reports (IPR), which are now available for review in the iQIES system. Agencies can now assess their current standing within their respective cohorts. The larger cohort includes agencies required to participate in HHCAHPS, while smaller cohorts comprise agencies small enough to be exempt from HHCAHPS participation.
The IPR reports bear a strong resemblance to the three pre-implementation reports you’ve previously received. A significant distinction, however, is that the current IPR reports utilize the updated benchmarks and thresholds from 2022 to calculate performance points and future payment adjustments. In contrast, the pre-implementation reports lacked the 2022 benchmark and threshold data, relying instead on information from a previous year.
As of July, the latest available IPR reports for OASIS items show data up to March 31, 2023. Specifically for HHCAHPS and Claims data, which includes acute care hospitalization and emergency department use, the data is only available up to December 31, 2022. This means we are currently lacking up-to-date activity reports, which creates a noticeable lag during our review process for this year.
The complete set of data for the entire year of 2023, encompassing both OASIS and claims with HHCAHPS data, will only be available in August 2024 IPRs along with the annual report.
During the demonstration, we were delighted to receive the additional report that contains the Total Normalized Composite Change Measures and a comparison with other agencies in the cohort. However, it’s crucial to remember that the Total Normalized Composite Change percentage information in this report is not risk adjusted. It is provided solely for informational purposes, allowing us to gauge our position on the individual OASIS items. Yet, these calculations are not risk adjusted and are not technically utilized in determining the Total Performance Score.
When reviewing your individual data on the summary page, you’ll notice your Total Performance Score’s percentile ranking. It could be less than 25th percentile, between 25th and 49th percentile, at the 50th percentile, 75th percentile, or even 99th percentile. To achieve a favorable outcome in the reimbursement impact calculation, your ranking needs to be at the 51st percentile or higher. Therefore, if you currently rank below the 51st percentile, it’s crucial to focus on improving the areas that contribute to a low performance measure calculation. This way, you can boost your scores for the remainder of this year.
We will soon be hosting an in-depth webinar that will cover the content of the IPRs, provide guidance on how to review them, and share best practices to enhance your scores. We encourage you to keep an eye out for this upcoming event.
Should you require any assistance from Healthcare Provider Solutions, please feel free to get in touch.
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