In recent years, the Medicare home health program has grown quickly, both in cost and the number of patients served. In 2009, 3.3 million Medicare beneficiaries received Medicare home health services, resulting in $18.9 billion in Medicare payments. While the Medicare home health program continues to expand, there is mounting concern that the existing payment system does not offer the necessary incentives to provide high-quality, patient-focused care. In January 2015, the U.S. Department of Health and Human Services announced an aggressive shift from volume-based Medicare payments to value-based Medicare payments. Their goals for this included tying 85% of Medicare fee-for-service (FFS) payments to performance and to transition at least 30% of all FFS payments to alternative payments by the end of 2016. The Centers for Medicare & Medicaid Services (CMS) views the implementation of a home health value-based purchasing program as a positive change in how Medicare pays for home health services, moving from rewarding volume of services provided to compensating for better value, outcomes, and patient-focused care.