14
The Home Care Association of Florida
FEATURE
CMS Considers a Value-Based Purchasing
Program for Home Health Care Agencies
By John Olajide
A
s part of the U.S. Affordable
Care Act (ACA), the U.S.
Department of Health and
Human Services (HHS) and
the Centers for Medicare & Medicaid
Services (CMS) are rolling out value-based
purchasing (VBP) payment programs across
a broad spectrum of health care providers
and settings in an effort to improve the
value of services.
According to an HHS report, VBP is a
broad set of performance-based payment
strategies that link financial incentives to
health care providers’ performance on a
set of defined measures. Both public and
private payers are using VBP strategies in an
effort to drive improvements in quality and
to slow the growth in health care spending.
VBP programs are being applied
to physicians, long-term hospitals,
rehabilitation hospitals, cancer hospitals,
psychiatric hospitals, skilled nursing
homes, ambulatory surgery centers, home
health agencies and hospice facilities.
CMS has already begun implementing
a Hospital VBP program to reward
hospitals based on the quality of care
provided to Medicare patients, adherence
to best clinical practices and how well the
hospital enhances the patient’s experience
of care. The Hospital VBP program
became effective for payments beginning
in fiscal year 2013 and affects payment for
inpatient stays in 2,985 hospitals.
While the ACA has no statutory
requirement to implement a Home
Health Agency (HHA) VBP program, the
development of an implementation plan is
required for Medicare providers. CMS has
recently proposed such a plan for home
health care agencies (HHAs) in an effort
to move toward rewarding better value
at an affordable cost, improved patient
outcomes, and patient-focused care instead
of the volume of services provided. HHS
has provided Congress with a proposed
plan to implement a Medicare Home
Health Agency VBP Program. CMS has
also collected comments on the proposed
program from members of the home
health industry and is currently reviewing
them. Testing of the model is under
consideration to take place in five to eight
states in calendar year 2016.
An HHA VBP program would provide
value-based financial incentives for meeting
quality standards for particular performance
periods during a fiscal year. CMS is also
proposing that the HHA VBP program
align with the National Quality Strategy.
According to CMS, the strategy presents
three aims for the health care system:
•
Better Care:
Improve the overall
quality by making health care more
patient-centered, reliable, accessible
and safe.
•
Healthy People and Communities:
Improve the health of the United
States population by supporting
proven interventions to address
behavioral, social, and environmental
determinants of health in addition to
delivering higher-quality care.
