Value-Based Purchasing

The Value-Based Purchasing (VBP) Model

As I have communicated in past broadcasts, VBP is set to begin for the entire nation on January 1, 2023, dividing agencies across the nation into two cohorts: the large cohort and the small cohort. The large cohort will consist of agencies that have a large enough patient volume to be required to participate in HHCAHPS. If you do not have a large enough patient volume your organization will be in the small cohort.

The most recent information released, showed there will be over 7000 HHAs included in the large cohort, and just under 500 HHAs included in the small cohort.

In early May, the benchmark and achievement thresholds were released that will be utilized in the calculation of the Total Performance Scores (TPS) with the nationwide rollout of VBP. The benchmarks reflect the top 90th percentile of scores within the baseline year of 2019. The achievement thresholds represent the mean score of all agencies that are in the corresponding cohort. They separated the benchmark and achievement thresholds between a large and a small cohort.

There has been some confusion surrounding the claims data that will be utilized in the VBP rollout next year. The confusion is that two claims’ data elements are included in the VBP model, the acute care hospitalization measure and the emergency department use measure, both of which are being eliminated from the HHQRP beginning January 2023. They will continue to be utilized in the VBP TPS calculations, but they will not be replaced with the new measure that will be utilized in the HHQRP. Understand that the acute care hospitalization measure and the emergency department use measure, even though they will be removed from the HHQRP, will continue to be reflected and used in the calculations under the VBP model.

You want to prepare your agency for this coming implementation, including reviewing your score as well as looking at your outcome measures that are related to the associated measures that will be utilized in the VBP model and begin education in the elements that your agency may be deficient. Keep in mind that an agency must have at least 40 surveys returned from your beneficiaries for you to have a calculation of HHCAHPS scores in the VBP model.

Resource: https://healthcareprovidersolutions.com/value-based-purchasing-benchmarks-achievement-thresholds