Managing Home Health Margins Through Clinical Quality (Webinar Series)
Wednesday, February 18, 2026 (1:00 PM - 2:30 PM) (EST)
Description
3-Part Live Webinar Schedule (recordings available too): Wednesdays from 1:00-2:30pm (ET)
- February 18: Expanded Home Health Value-Based Purchasing (HHVBP) Model
- March 18: Payment Changes: What to Expect for Medicare Home Health Payments in 2026
- April 15: What Does This Mean for Revenue Cycle Management (RCM) and Agencies?
Background: Reflecting the CY 2026 Final CMS Home Health PPS Rule (click arrow to see more)
Home Health reforms continue with significant programming and reimbursement changes finalized in the Calendar Year (CY) 2026 Home Health Prospective Payment System (PPS) Final Rule. Providers preparing for success will face heightened challenges related to the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS®) survey and the expanded Home Health Value-Based Purchasing (HHVBP) Model—changes that coincide with substantial reimbursement reductions. The result is a Home Health landscape markedly different from the systems many agencies operated under during traditional PPS and the early Patient-Driven Groupings Model (PDGM) era.
Nationally, Home Health agencies have been focused on navigating finalized fiscal cuts and their downstream operational and margin impacts. As established models strain under PDGM, VBP, and HHCAHPS requirements, providers relying on legacy processes frequently find themselves facing eroded episodic margins. This instability threatens long-term sustainability, and nearly half of HH agencies continue to report negative margins.
In addition to the finalized payment cuts, the new HHCAHPS survey structure—effective beginning with the April 2026 sample month—directly impacts VBP scoring. CMS finalized the modernization of the HHCAHPS survey, reducing the total number of questions from 35 to 30 (adding three, removing eight). Because these changes materially impact baseline calculations, CMS removed the three existing HHCAHPS composite measures (Care of Patients, Communications Between Providers and Patients, and Specific Care Issues) from the HHVBP Model beginning in CY 2026.
In their place, CMS finalized the addition of four new measures to the HHVBP measure set beginning in Performance Year (PY) 2026:
- Medicare Spending Per Beneficiary – Post-Acute Care (MSPB-PAC)
- Improvement in Bathing (OASIS M1830)
- Improvement in Upper Body Dressing (OASIS M1810)
- Improvement in Lower Body Dressing (OASIS M1820)
The CY 2026 Final Rule establishes an overall payment decrease of 1.3% (–$220 million) compared to CY 2025. Finalized updates include adjustments to:
- LUPA thresholds
- PDGM case-mix weights
- Functional impairment levels
Part 1: Expanded Home Health Value-Based Purchasing (HHVBP) Model
Changes to the Applicable Measure Set
Beginning April 2026, CMS is proposing changes to the HHCAHPS survey. These changes affect the survey questions used to calculate three measures that are currently used in the expanded HHVBP Model. Due to the proposed changes to the HHCAHPS survey, CMS is proposing to remove these measures:
- Care of patients,
- Communications between providers and patients, and
- Specific care issues.
CMS is also proposing the addition of four measures to the applicable measure set. This includes three OASIS-based measures related to bathing and dressing, and one claims-based measure, the Medicare Spending per Beneficiary for the Post-Acute Care (PAC) setting measure.
Due to the changes to the Model’s applicable measure set, CMS is proposing to alter the current weights of individual measures and measure categories.
CMS is proposing a new criterion ("Factor 9") to have explicit regulatory authority to remove quality measures if they sound good in theory but turn out to be too difficult or impossible to actually put into practice (§ 484.358).
HHVBP Quality Measure Concepts Under Consideration for Future Years – Request for Information (RFI)
CMS is including in the proposed rule an RFI that would build on input from the expanded HHVBP Model’s Implementation and Monitoring technical expert panel (TEP). We are specifically asking for feedback about the addition of a respecified Falls with Major Injury measure as well as two potential changes to the HHCAHPS survey-based measures scoring rules and applicable measure set as they relate to the expanded HHVBP Model.
Meet the Speakers
Arnie Cisneros is the President of Home Health Strategic Management (HHSM). He has over 30 years of experience as a physical therapist across the care continuum, and he serves as a Post-Acute Consultant for multiple Pioneer Accountable Care Organizations (ACOs). He is renowned for his adaptation of traditional health care operations to address ongoing Centers for Medicare & Medicaid Services (CMS) reforms.
Kimberly McCormick is a highly accomplished nurse consultant in home health. She is the Executive Clinical Director for Home Health Strategic Management. With 24 years of experience in home health, including nearly a decade as the administrator of a home health agency, Kimberly has the experience and knowledge to provide unrivaled insight into the home health arena. Kimberly previously served as an Associate Consultant with HHSM, where she has established herself as an expert in the utilization management of home health services.
Continuing Education
Attendees receive 1.5 continuing education units per webinar for Florida-licensed skilled nursing, occupational therapy, and speech-language pathology and audiology.
Call for Sponsors
Interested in sponsoring the webinar? Contact us for details.
Register online or call (850) 222-8967 to register by phone. HCAF members receive a discounted registration rate! To obtain the member discount, please log in to your profile before registering.
Single Webinar
HCAF Members: $49
Prospective Members: $98
Full 3-Part Series
HCAF Members: $119
Prospective Members: $238
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