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Updates to the Expanded Value-Based Purchasing Model Included in the 2023 Home Health Payment Final Rule

Updates to the Expanded Value-Based Purchasing Model Included in the 2023 Home Health Payment Final Rule

Medicare

On October 31, 2022, the Centers for Medicare & Medicaid Services (CMS) published the Calendar Year (CY) 2023 Home Health Prospective Payment System (HH PPS) final rule on the Federal Register. This final rule sets forth the changes to the expanded Home Health Value-Based Purchasing (HHVBP) Model Expansion Model’s baseline year and home health agency baseline year.

The evaluation findings of the HHVBP Model in the nine states that originally participated in the program showed that participants’ performance from 2016-2018 achieved an average 4.6% improvement in quality scores as well as average annual savings of $141 million to Medicare. The CMS Chief Actuary’s certification and determinations made by the Secretary designated the HHVBP Model as eligible for expansion nationwide through rulemaking. On January 8, 2021, CMS announced its intention to expand the Model no earlier than January 1, 2022, through notice and comment rulemaking, and a proposal for nationwide expansion was included in the CY 2022 HH PPS proposed rule.

The HHVBP Model is one of four Innovation Center models that have met the requirements to be expanded in duration and scope since 2010. Given this expansion, CMS is also ending the HHVBP Model for participants in the original model’s nine states. The first performance year of the expanded HHVBP Model will be CY 2023, with quality performance data from that year used to calculate payment adjustments under the expanded Model in CY 2025. Throughout 2022, CMS will provide technical assistance to providers to ensure they understand how performance will be assessed as finalized in this rule.

Information and resources designed to support home health agencies with understanding the expanded HHVBP Model and continue to prepare for the first performance year, which begins January 1, 2023, are available for download from the Expanded HHVBP Model webpage.

For program questions about the HHVBP Model, contact the HHVBP Help Desk at HHVBPquestions@lewin.com.

Final Rule Analysis Home Care Connection Events Kick Off Next Week

HCAF's Fall 2022 Certified Home Care Connection series starts next week with a presentation by Healthcare Provider Solutions CEO Melinda Gaboury on all aspects of the 2023 Medicare final rule, including:

  • Expansion of HHVBP nationwide;
  • Patient-Driven Groupings Model (PDGM) changes; and
  • Modifications to the Conditions of Participation (CoPs).

Gaboury will also review the progress of the Medicare Review Choice Demonstration (RCD). Click here to watch a preview to learn more about this timely program.

Additionally, HCAF Executive Director Bobby Lolley, RN, and Director of Government Affairs and Communications Kyle Simon will review what's happening in Congress pertaining to home health, preview what providers can expect during the 2023 Florida Legislative Session, and discuss industry trends.

Participants receive 2.0 continuing education units for nursing, occupational therapy, and speech-language pathology.

Click here to find an event near you and register now.

Additional Info

Source : https://www.cms.gov/newsroom/fact-sheets/cy-2023-home-health-prospective-payment-system-rate-update-and-home-infusion-therapy-services-0

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