In January 2016, the Centers for Medicare & Medicaid Services (CMS) rolled out the Home Health Value-Based Purchasing (HHVBP) model in nine randomly selected states (Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, and Washington).

The original HHVBP Model leveraged the successes and lessons learned from other value-based purchasing programs and demonstrations to shift from volume-based payments to a model designed to promote the delivery of higher quality care to Medicare beneficiaries. The overall purpose of the HHVBP Model was to improve the quality and delivery of home health care services to Medicare beneficiaries with specific goals to:

Provide incentives for better quality care with greater efficiency
Study new potential quality and efficiency measures for appropriateness in the home health setting
Enhance the public reporting process

The CMS has designed HHVBP Model to give Medicare-certified home health agencies (HHAs) incentives to provide higher quality and more efficient care.

HHVBP pilot program resulted in an average 4.6 percent improvement in HHAs' total performance scores (TPS) and an average annual savings of $141 million to Medicare without evidence of adverse risks. The evaluation of the original model also found reductions in unplanned acute care hospitalizations and skilled nursing facility (SNF) stays, resulting in reductions in inpatient and SNF spending. The U.S. Secretary of Health and Human Services determined that expanding the original HHVBP Model would further reduce Medicare spending and improve the quality of care. In October 2020, the CMS Chief Actuary certified that expansion of the HHVBP Model would produce Medicare savings if expanded to all states.

As part of the final rule for 2022, CMS is moving forward with expanding HHVBP Model to all 50 states.

This blog reviews the must-have functionalities in your home care agency management software platform to help you succeed in the HHVBP Model.

HHVBP Must have features in Home Healthcare Software

How can your Home Healthcare software help with HHVBP?

HHVBP represents the most significant change to provide incentives (or penalties) to Medicare Certified Home Health Agencies to give higher quality and more efficient care. Home Health Care Agencies should have the right tools to monitor OASIS Based and Claim Based Measures throughout the year to help them adjust the care delivery process to improve patient outcomes. The software platform will play a critical role in helping Home Health Agencies meet the challenges of HHVBP.

The following are some of the ways your software platform can help,

Patient Level OASIS Alerts

To effectively manage and succeed in HHVBP Model, Home Care Agencies will need tools to monitor OASIS Based Measures at the patient level. The software should provide proactive alerts at the point of care when there is a change or decline in OASIS Based Measures during ROC or Discharge assessments. These alerts will enable clinicians to review the care and the documentation and adjust care to improve outcomes. Viewing the trend of these measures will also help agencies monitor and improve outcomes one patient at a time. Configurable validations will help home health care agencies to provide additional alerts based on the process established at the point of care.

Communication

Effective communication is key to improving the quality of care, patient satisfaction, and employee satisfaction. A robust communication architecture enhances patient outcomes and delivers better patient survey results.

Home Care Software platform should have a HIPAA Compliant Secure messaging function to communicate with employees and patients. It should have a HIPAA Compliant Secure messaging function to communicate with employees and patients. Communication logs should be available to document communication about patient care and make it available for all team members. The software should have tools to send out schedule reminders and changes to employees and patients. Clinical communication, such as providing a complete clinical picture of the patient at the point of care, and disseminating changes to patient care in real-time, will improve the quality of care, patient safety, and satisfaction.

ED Use and Acute Care Hospitalization

Emergency Department (ED) use and Acute Care Hospitalization play an outsized role in determining HHVBP score for Home Health Care Agencies. Agencies should be able to easily track ED use and hospitalizations during care and after discharge. Providing proactive alerts when there is ED Use or hospitalization of a patient and summary reports will help agencies to monitor and manage ED use and hospitalization.

Reports and Dashboards

The Home Health Care Software platform should have detailed, and summary reports for HHVBP measures. These reports should provide trending options for these measures enabling the agencies to monitor the trend throughout the year and adjust the care delivery process to improve outcomes. A dashboard of these measures with trending will be handy for senior-level managers to monitor and assess the impact of HHVBP scores on agency operations.

Reimbursement Factor

The Home Health Care Software platform should have a place to enter the HHVBP Reimbursement Factor (Bonus/Penalty) and adjust PDGM Reimbursement accordingly. This feature will help agencies manage cash flow based on actual reimbursements, including HHVBP adjustment.

Conclusion

The Home Health Care Agency Management software platform should provide the necessary tools to monitor HHVBP Measures during the year effectively. These tools help agencies stay on top of HHVBP throughout the year instead of scrambling to measure the impact of HHVBP adjustments at the end of the year.

About CareVoyant

CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.

CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.

For more information, please visit CareVoyant.com or call us at 1-888-463-6797.