Calue Based Purchasing Program

Value Based Purchasing Proposed for Home Health

HEALTHCAREfirst to Host Webinar.

CMS issued its annual proposal to adjust home health PPS rates in the Federal Register on July 10, 2015. In addition to revisions to the home health PPS case-mix weights and reductions to the national, standardized 60-day episode payment rate, CMS announced its plans to introduce a Home Health Value-Based Purchasing model (VBPHH). Their intent is to fashion HHVBP after the “successfully implemented” Hospital Value Based Purchasing (HVBP) program.

The proposed model will be tested in nine states by CMS’s Center for Medicare and Medicaid Innovation (CMMI) over a five year period, beginning January 1, 2016. All Medicare-certified HHAs that provide services in Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee will be required to compete in this model. HHAs in the designated States will receive either a reduction or an increase of up to 8 percent, depending on their performance in specified quality measures when compared to their peers.

CMS proposes to evaluate home health agencies using a “Starter Set” of quality measures during the first year. The model’s “Starter Set” will be comprised of data from OASIS, Medicare claims, and HHCAHPS, along with new measures that will be reported directly to CMS through a web portal. In subsequent years, new and evolving measures will be considered for inclusion in the model through future rulemaking.

Please join Mary St. Pierre, HEALTHCAREfirst Consultant and former NAHC Vice President of Regulatory Affairs, and Deanna Loftus, Director of Regulatory Compliance with HEALTHCAREfirst, for a free regulatory webinar on August 6, 2015 regarding on the CY 2016 Proposed Rules. A detailed description of the proposed HHVBP program, including the geographic selection methodology, payment adjustment timelines, proposed quality measures, and performance scoring methodology will be presented. Click here to register.

About Mary St. Pierre
After retiring from the National Association for Home Care & Hospice (NAHC) in 2013, Mary St. Pierre served as a national home health and hospice consultant. At this time she is engaged in an exclusive consulting agreement with HEALTHCAREfirst, providing regulatory guidance in the design and maintenance of software and data analytics. While with NAHC, Ms. St. Pierre oversaw the operations of the Regulatory Affairs Department, tracking regulations and influencing regulatory bodies such as CMS, FDA, and OSHA.  In addition, she prepared educational programs, presented speeches and programs and kept the membership abreast of regulatory and clinical information through articles in NAHC publications.  Ms. St. Pierre had 26 years experience as a home care nurse, clinical supervisor and manager within a large metropolitan home health agency prior to joining NAHC in 1993.

July 31, 2015

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