Welcome to Swift Medical’s multi-part series on the new Home Health Value-Based Purchasing Model.

Feeling unsure about what impact the upcoming Home Health Value Based Purchasing Model (HHVBP) will have on your organization? You’re not alone. A recent survey by Home Health Care News found that 63% of home health providers were unsure or indifferent about the impact it has made on their organizations thus far. And yet despite this, 42% of respondents believe that value-based contracts will account for more than half or most of their organization’s revenue in the next 3-5 years.

Over the course of this series we will provide an easy to understand overview of the mechanics of the Home Health Value Based Purchasing (HHVBP) Model and the move to a discussion of how improving your wound care program can improve performance against key HHVBP metrics: hospitalizations and patient satisfaction. 

In this installment, we cover the following:

From volume to value: improving the quality of care delivered

When will the Home Health Value Based Purchasing Model (HHVBP) impact my agency?

What outcomes are being measured under the Home Health Value Based Purchasing Model (HHVBP)?

How are scores calculated under the Home Health Value Based Purchasing Model (HHVBP)?

How can my agency set itself up for success under the Home Health Value Based Purchasing Model (HHVBP)?


From Volume to Value: Improving the quality of care delivered

Value-based care delivery is by no means unique to home health. Over the past decade, CMS has explored various funding programs that look to incentivize care providers to shift away from fee for service reimbursement to payment models centered around quality outcomes. 

At the start of 2016, CMS launched an initial pilot of HHVBP across 9 test states. Designed to provide financial incentives to home health agencies to improve the quality of care delivered, it rewarded agencies with high quality scores with additional revenue on medicare fee for service reimbursements and reduced payments to agencies with lower performance scores. 

According to CMS, the model has resulted in an average 4.6% improvement in home health agencies’ quality scores as well as average annual savings of $141 million to Medicare. The success of the pilot has prompted CMS to expand the program nationwide starting in 2023.

When will the Home Health Value Based Purchasing Model Impact my agency?

For agencies beyond the initial 9 test states, the first “performance” year of HHVBP starts in 2023. Your outcomes for 2023 will be compared against your performance in 2019, known as the “baseline” year. In 2025, CMS will adjust its 2023 payments to your agency for services rendered to Medicare fee for service patients by up to ±5% based on performance. 

What outcomes are being measured under the Home Health Value Based Purchasing Model?

HHVBP performance measures can be divided into 3 categories: OASIS, Claims, and the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey.

How are scores calculated under the Home Health Value Based Purchasing Model (HHVBP)?

While the specifics of how scores are calculated can be somewhat complex (more information available here via CMS), the principle behind it is relatively simple. CMS will evaluate each performance measure against either the agency’s own past performance (Improvement Score) or against the performance of other home health agencies (Achievement Score), whichever is higher.

How can my Agency set itself up for Success under the Home Health Value Based Purchasing Model?

It is worth noting that not all performance measures are weighted equally. Claims-based performance measures (i.e. hospitalizations) are weighted most heavily, meaning that any measure taken to reduce these costly events will significantly improve your agency’s performance. What many don’t realize is that wounds are the single greatest risk factor for home health hospitalizations, increasing the risk of hospitalization by 52% (more than any other diagnosis or factor). Swift Medical has a proven record of reducing hospitalizations in just 6 months, which means agencies that are searching for high-impact strategies to improve their HHVBP performance need look no further than that the leading digital wound care solution.

In the next entry in this series, we go into more detail about how exactly Swift can help improve your performance against claims-based performance measures (hospitalizations) to enable your agency to thrive under the new HHVBP funding model.


Our latest webinar with Maxwell Healthcare Associates provides a better understanding of how your agency can thrive under the value-based purchasing model by adopting digital wound tools that help:

  • Reduce rehospitalizations;
  • Improve the quality of care, and;
  • Enhance patient and provider satisfaction.
Download the full recording:

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