WASHINGTON, D.C. (April 28, 2022)—Home health providers participating in the Home Health Value-Based Purchasing (HHVBP) model are performing 7% better than their counterparts, according to a new report from the Center for Medicare and Medicaid Innovations (CMMI). The model covers Medicare-certified home health providers in Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska and Tennessee.
The annual Home Health Value-Based Purchasing Report, which covered the 2020 reporting year, also detailed a decrease in unplanned hospitalizations, emergency department (ED) visits leading to inpatient admission and skilled nursing facility use by fee-for-service beneficiaries using home health. The gains were offset by 2.5% increase in outpatient ED visits. An increase in ED visit without hospitalization among the HHVBP participating agencies has been seen throughout the five years of the demonstration.
The HHVBP continued to show a cumulative savings of $949.2 million to the Medicare program during the five-year demonstration project. The savings have largely been driven by a 2.8% reduction in inpatient hospitalization stay spending and a 4.0% reduction in skilled nursing facility services spending. However, savings were offset by a 6.4% increase in outpatient ED and observation stay spending.
As first noted in last year's report, this model continued to show a decrease in unplanned hospitalizations and improvement in two functional status measures for non-Medicaid patients, but not for Medicaid patients. These patterns remain similar between the baseline period and the post-HHVBP period. There was no consistent pattern in effects of HHVBP across racial/ethnic minority groups and no overall effect on use of home health services and no adverse effects on access to home health care.
Although three of five measures of patient experience with care declined slightly, the model improved home health patients’ mobility and self-care as well as other aspects of functional status. The Centers for Medicare & Medicaid Services has announced plans to expand the program nationwide.