Expanded Home Health Value-Based Purchasing Model

The Expanded Home Health Value-Based Purchasing (HHVBP) Model seeks to improve the quality and efficiency of home health care across the nation to improve patients’ experience with their care, strengthen their physical function and address health issues before they require an emergency room visit. The expanded model also builds on the success of the original model, which decreased unnecessary emergency room visits, improved patient mobility, and reduced Medicare spending.

Calendar Year (CY) 2025 is the first payment year, with payment adjustment amounts determined by CY 2023 performance. In a payment year, an applicable payment adjustment ranging from - 5 to 5 percent applies toward Medicare fee-for-service payments. Payment years are determined by the claims 'Through' date, meaning claims that span into CY 2025 will receive the CY 2025 payment update and CY 2025 HHVBP payment adjustment (determined by CY 2023 performance). Providers are encouraged to review both the interim and annual performance reports (APRs) in the Internet Quality Improvement and Evaluation System (iQIES) portal.

Claim value code QV (Medicare-applied code) identifies the dollar amount of the difference between the agency’s HHVBP positive or negative adjusted payment and the payment amount that would have otherwise been made.

If you are interested in receiving additional educational information, updates or have questions about the Expanded HHVBP Model, please see the below resources:

• CMS HHVBP Website: Expanded Home Health Value-Based Purchasing Model 
• HHVBP Listserv: Subscribe to the HHVBP Model Expansion listserv
• Help Desk: HHVBPquestions@cms.hhs.gov
• Annual Performance Report (APR): Instructions for Accessing HHVBP Model Reports in iQIES