What HHVBP Means for Managed Care, SNF Utilization – Home Health Care News


stevepb/Pixabay | CC0
stevepb/Pixabay | CC0

With the nationwide rollout of the Home Health Value-Based Purchasing (HHVBP) Model inching closer, home health agencies are feeling confident about their ability to adapt.

Not only are operators confident, but some are even excited about what HHVBP might translate to in terms of improved managed care relationships and further diversion away from skilled nursing facilities (SNFs).

“If we do well under HHVBP, that should help prove the value of home health care,” one executive recently told me. “Medicare Advantage [plans] can see all of that information.”

Yet with roughly seven-and-a-half months to go, more questions about HHVBP’s broader impact on quality of care and patient access are starting to pop up. This year’s annual evaluation report on HHVBP, for example, suggests there’s a gap between the care fee-for-service Medicare beneficiaries receive and those who also have Medicaid coverage.

“If HHVBP does not uniformly affect all patients in the same way, the model could have important implications for health equity,” noted the report’s authors, who worked for both the Arbor Research Collaborative for Health and L&M Policy Research.

Home Health Care News has written about the 50-state HHVBP expansion extensively. But after talking to more executives about HHVBP and reading through the recently released 169-page evaluation, I wanted to share a few new big-picture insights on the model.

In this week’s exclusive, members-only HHCN+ Update, I analyze the latest on HHVBP and offer key takeaways for home health agencies, including:

– HHVBP puts home health agencies in a better position to demonstrate value to managed care. But payer partners want to be “wowed” by data, and evidence suggests that HHVBP mostly leads to relatively modest quality improvements.

– With agencies participating in the nine-state HHVBP demonstration, there was a clear decrease in SNF utilization. This could be one of the most significant macro-level consequences of value-based purchasing if that trend holds in 2023 and beyond.

– Already, there have been concerns that HHVBP will incentivize home health operators to focus on patient populations associated with positive-payment adjustments. New data supports that idea, meaning changes to HHVBP’s design are likely, given regulators’ current prioritization on health equity and access.


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When Robert’s not covering the latest in home health care news, you can likely find him rooting for the White Sox or roaming his neighborhood streets playing Pokemon Go. Before joining HHCN, Robert covered everything from big agribusiness to the hottest tech startups. 

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