Competition in the home health value-based purchasing model is heating up, so providers should embrace change, new technology and innovative practices to optimize their financial rewards, home care consultants said during the National Association for Home Care & Hospice’s 2024 Financial Management Conference in Las Vegas.

“The quality is increasing, and we see that agencies are improving, so that means the bar is higher as time goes on,” Yancey McManus, senior director of solutions management at healthcare analytics firm WellSky, told providers this week. “This is great news for our patients, but with all the challenges and requirements that your quality is measured on, it’s very important that you focus on doing more with less. That’s where change comes in.”

HHVBP compiles quality measures based on home health agencies’ Star Ratings, Outcome and Assessment Information Set data and Home Health Consumer Assessment of Healthcare Providers and Systems results to generate a Total Performance Score, which influences providers’ reimbursement rates. Providers are judged against their past performance and that of their peers. Therefore, investing in practices that lead to better outcomes is strategic.

RPM’s value in HHVBP Model

Since the heaviest-weighted quality measure is providers’ rate of potentially preventable hospitalization claims, tools that can prevent patients from going to the hospital are especially valuable, according to Cindy Campbell, WellSky’s senior director of advisory services.

“We should be monitoring more,” Campbell advised. “[Remote patient monitoring] works.”

Home health agencies can use remote patient monitoring (RPM) to gather data on patients’ social needs, Campbell explained, allowing them to better tailor care and reduce poor outcomes like hospitalizations. And while RPM utilization is increasing in home care, more can always be done to gather data on patients’ health — especially during the times in between home visits, according to Campbell.

“Value in home care is created in the home,” she said. “Therefore, the more visibility you have into patients’ homes, the better.”

Educate on HHCAHPS

The patient experience also has to be considered, Campbell and McManus explained. HHCAHPS surveys, wherein clients report their satisfaction with care, play a big part in determining providers’ performance scores under HHVBP. However, survey response rates tend to be low in home health; this hinders providers’ HHVBP success. Historically, less than a quarter of patients submit HHCAHPS surveys. 

“HHCAHPS is the underdog, and it’s not talked about enough in HHVBP,” Campbell said.

She recommended that providers teach home health workers how to prepare clients for the survey. Teaching clinicians specific scripts with which they can introduce patients to the survey and educate them on how to submit responses can improve response rates, she said. Additionally, encouraging home care workers to be polite and friendly can also improve patients’ satisfaction, which oftentimes generates better survey responses. And by generating more positive HHCAHPS responses, providers can lessen the negative impact of a bad survey.

“From the first moment you walk in the door to when you exit on that last visit, that is going to impact HHCAHPS,” Campbell said.

The McKnight’s Tech Daily is an e-newsletter for the audiences of McKnight’s Long-Term Care News, McKnight’s Senior Living and McKnight’s Home Care.