Home Health Articles and Information


Apr 22, 2021 8:36:24 AM / by Michael McGowan, CEO, OperaCare LLC.

The Expansion of HHVBP

In January 2021 CMS certified the Home Health Value-Based Purchasing (HHVBP) for expansion to begin in Calendar Year (CY) 2022. The HHVBP model, which has been implemented in nine states, has resulted in an average 4.6% improvement in home health agencies’ quality scores as well as average annual savings of $141 million to Medicare. These impressive results have been certified by the Chief Actuary of CMS.

The concept of more value in health care is not new. The Institute for Healthcare Improvement (IHI) published the “Triple Aim” in 2007, which is a design to simultaneously carry out three elements:

  • Improving the patient experience of care
  • Improving the health of populations; and
  • Reducing the per capita cost of health care



Based on this, CMS has been working toward a value-based design since the legislation passed to implement it in 2008 and 2010. In fact, CMS has been steadily adding to its value-based programs since the first three were introduced in 2012.

The last two value-based programs to begin piloting where the SNF and the HH programs. These programs have specific challenges due to the age, underlying chronic health conditions, and advancing numbers of this patient population. The success of HHVBP gives CMS an understanding of the mechanics required to successfully manage post-acute care.

Because “Value” is defined by monetary savings to “the program” quality patient outcomes, and the cost of care to achieve those outcomes, we have must begin to think differently…


Profits are made by managing the patient to improve outcomes while reducing the cost of care, not by INCREASING the reimbursement you receive.


How can your HHA start to prepare now?


STEP 1- Identify the unwarranted variables of care in your QA, therapy, and nursing departments. Make sure there is no waste in your home health practice.

STEP 2- Develop a plan to reduce any variables or waste discovered.

STEP 3-Identify and quantify the resistance to change in your organization and develop plans for dealing with it.

STEP 4-Develop a plan to sustain the changes required to be in the bonus group.


Tags: PDGM, Value-based care, Compliance, Home Health, Quality assurance, Home Health Care

Michael McGowan, CEO, OperaCare LLC.

Written by Michael McGowan, CEO, OperaCare LLC.

Michael McGowan is a former State/CMS Region IX OASIS coordinator and president of OPERACARE. Based in Socorro NM. The company utilizes proactive OASIS analytics to exploit the entirety of PPS system, establish financial predictability, minimize ADR’s & Audit risks, and monitor OASIS outcomes. The company’s remote monitoring services mimic Intermediaries and audit contractor’s activities to quantify your risks and validate the care you deliver.