Courtesy of the National Association for Home Care & Hospice (NAHC)

The Center for Medicare & Medicaid Innovations (CMMI) has released the fifth Home Health Value-Based Purchasing (HHVBP) model annual report.

The report shows that total performance scores were 7% higher among agencies in HHVBP states than agencies in non-HHVBP states in 2020, 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 a 2.5% increase in outpatient ED visits. An increase in ED visits 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 the fourth annual report, this report 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 the 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.