If you operate a home health agency, big changes are coming in the new year. Beginning on January 1, 2023, all Medicare-certified home health agencies must participate in the new Home Health Value-Based Purchasing (HHVBP) model. By linking payments to performance, HHVBP rewards your home health agency for the quality of your patient outcomes rather than the quantity of the services you provide. According to CMS, the new model is expected to deliver savings of $3.376 billion from 2023 to 2027.Going forward, it will be more important than ever for your home health agency to deliver quality patient outcomes, operate with the utmost efficiency and receive excellent scores for patient satisfaction. A variety of measures— from acute care hospitalizations to management of oral medications to patient communication—will be used to evaluate the operations of each home health agency, resulting in a Total Performance Score (TPS).
Once the TPS is calculated, your home health agency’s score will be measured against comparable agencies nationwide to determine how well you’re performing. If you receive higher TPS scores relative to your peers, your agency will receive a 5% payment increase, while agencies with lower scores in relation to the competition will receive a 5% cut in payments. In this era of low margins in home health care, these payment adjustments are certain to have a big effect on your annual financial results.
Seven Ways to Improve Your Performance Scores.
Your home health agency should be making plans now to adapt to the new purchasing model. Here are seven recommendations that could help you deliver more efficient care and achieve higher performance scores.
- Focus on measures with the greatest impact. By a large margin, acute care hospitalization rates will have the biggest influence on your agency’s TPS. You should concentrate most of your efforts in this area by taking a coordinated team approach to patient care and ensuring that patients clearly understand their post-hospitalization instructions.
- Identify high-risk patients. Readmissions can also be reduced by making everyone on your care team aware of the patients who are at higher risk, as well as the reasons why they are at risk—from the possibility of falls to poor medication management. Greater attention to these patients can help your agency dramatically reduce readmissions and/or visits to the ED, and therefore lift your TPS.
- Develop specific, written plans to improve outcomes. Everyone in your agency should understand the ramifications of the new purchasing model and be working toward the same goals. Consider creating a written document that clearly delineates the steps to be taken to improve scores in specific areas. This can become an adjunct to your existing Quality Assurance and Performance Improvement (QAPI) program. The plan should assign responsibilities for each initiative, create timetables to follow up on tasks and set clear due dates.
- Front-load and stagger patient visits. IN the HHVBP pilot, CMS saw evidence that agencies with lower hospitalization rates tended to front-load their patient visits in the home. Seeing patients with greater regularity soon after discharge and then staggering visits from different team members thereafter can be a very successful care strategy. Interdisciplinary collaboration is the key to achieving the best possible outcomes.
- Accurately document patient status. OASIS measures will be responsible for a full 35% of an agency’s TPS. To achieve higher scores, your team members should carefully document the social, functional and clinical status of the patient at specific times.
- Review everyday customer service practices. Through HHCAHPS, patients will complete surveys to measure their satisfaction with the quality of care. It will be critical for your agency to implement processes to effectively manage requests and changes in patient status. When abnormal signs and symptoms appear, physicians should be immediately contacted to set up in-person or virtual visits. When patients contact the agency, all of their concerns should be fully addressed with prompt follow-up. This extends to everyone in the agency, from in-home caregivers to staff members answering billing questions. Attention to detail and competent care at every touchpoint will be vital to achieve better patient satisfaction scores.
- Implement remote patient monitoring. To deliver higher-quality care more efficiently, many home health agencies are turning to centralized telehealth and remote patient monitoring (RPM) from Health Recovery Solutions (HRS). In fact, HRS is currently used by more than 40% of the largest home health agencies in the United States. Our innovative systems—which can range from all-encompassing patient monitoring to tablet-based solutions—offer benefits directly related to the most important value-based purchasing measures. These include a reduction in hospital readmissions and ER visits, closer monitoring of patient status and improved scores for patient satisfaction. Comprehensive patient monitoring can be particularly helpful for managing high-risk patients who have the greatest likelihood of returning to the hospital. HRS also provides extensive training on the systems for your employees, and patients can call with questions 24 hours a day. With all of these benefits, it’s easy to see why HRS was named Best in KLAS for Remote Patient Monitoring for four consecutive years from 2020-2023.
Want to learn more about the HHVBP Model? Download our free, in-depth white paper today.
How RPM Can Help Raise HHVBP Scores
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In the new world of value-based purchasing, home health agencies that incorporate these recommendations into their care plans could have an advantage in the effort to attain higher scores —and higher reimbursements—in the years ahead.
For an in-depth break down of the HHVBP Model, check out our free webinar session today.