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Post-Acute Care Quality Programs





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Expanded HHVBP Model: March 2025 Newsletter

*QUARTERLY NEWSLETTER – MARCH 2025*

This newsletter contains information for home health agencies (HHAs) related to the expanded Home Health Value-Based Purchasing (HHVBP) Model, including Model highlights, training updates, new insights, reminders, resources, and contact information.

*IN THIS ISSUE:*


* Interim Performance Reports (IPRs) – Final January 2025 IPRs Available on iQIES
* Public Reporting – First Performance Year Results Now Available in the Provider Data Catalog
* Getting Ready for the CY 2025 Measure Set – Available and Upcoming Resources
* Help Desk Highlights
* HHVBP Resources
* Contact Us

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*January 2025 Interim Performance Reports (IPRs) – Final January 2025 IPRs Available on iQIES*

The Final January 2025 IPRs for the expanded HHVBP Model have been published on the Internet Quality Improvement and Evaluation System (iQIES). *_New in the January 2025 IPRs is a worksheet ("CY 2025 Baseline") that reports on your HHA's preliminary Improvement Thresholds for the CY 2025 applicable measure set._* Note that Improvement Thresholds are based on CY 2023 data for all measures in the CY 2025 measure set other than the DTC-PAC measure. For the DTC-PAC measure, CY 2022 and CY 2023 data are used.  

An HHA receives a January 2025 IPR if the HHA:


* Was Medicare certified prior to January 1, 2023, and
* Meets the minimum threshold of data for at least one (1) quality measure in the quarterly reporting period for the performance year shown in* Exhibit 1. *

*Exhibit 1: *January 2025 IPR quality measure performance scores time periods for each measure category

Table 1

* Not included in the TPS calculation for HHAs in the smaller-volume cohort.

*Note: *IPRs are only available to HHAs through iQIES. IPRs are not available to the public. 

Instructions on how to access the IPRs are also available on the Expanded HHVBP Model webpage [ https://links-2.govdelivery.com/CL0/https:%2F%2Flinks-2.govdelivery.com%2FCL0%2Fhttps:%252F%252Fwww.cms.gov%252Fpriorities%252Finnovation%252Finnovation-models%252Fexpanded-home-health-value-based-purchasing-model%2F1%2F01010193e6816bb0-194cc20b-47b9-4f1f-a36c-be5d5a80394e-000000%2FL_QADl6cojBTzaTYjltL-9qDZvM0G96F25v8MsjrmyU=384/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/pSjJVVmWwX9-a9ohTXMuf-9Ym_gjqzuocGapeFPYThQ=399 ], under “Model Reports.”

 

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*Public Reporting – First Performance Year Results Now Available in the Provider Data Catalog*

On January 15, 2025, CMS posted results from the first performance year of the expanded HHVBP Model (CY 2023) in the Provider Data Catalog.

One of the overall goals of the HHVBP Model is to enhance the public reporting process. Posting results from the first performance year of the expanded HHVBP Model (CY 2023) in the Provider Data Catalog (PDC) [ https://links-2.govdelivery.com/CL0/https:%2F%2Flinks-2.govdelivery.com%2FCL0%2Fhttps:%252F%252Fdata.cms.gov%252Fprovider-data%252Ftopics%252Fhome-health-services%2F1%2F0101019489ed6fae-7e206680-8453-4236-810d-3ae0f89bb442-000000%2FVBr1vJf-lKNGLoESufgGtwWpdApx4Xgvelf9QnJeuCw=388/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/zjlMm0Jh34L5a0FmVs2QvHWlNgcd75B7zb09e46ly4s=399 ] is an important milestone toward meeting this goal. CMS plans to update expanded HHVBP Model performance data annually.

Please review the Public Reporting Tip Sheet: Home Health Value-Based Purchasing [ https://links-2.govdelivery.com/CL0/https:%2F%2Flinks-2.govdelivery.com%2FCL0%2Fhttps:%252F%252Fwww.cms.gov%252Fpriorities%252Finnovation%252Ffiles%252Fhhvbp-public-reporting-tip-sheet.pdf%2F1%2F0101019489ed6fae-7e206680-8453-4236-810d-3ae0f89bb442-000000%2FyI1kU21JM128uXSyTWMLbUivupc_8LpSKlFGvt7WLTA=388/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/QOURhMABWU1OB6ufEs1tki9k-zcxlsCffkmm57sQlhs=399 ] for additional details on HHVBP public reporting. For more information about the expanded HHVBP Model, including the expanded HHVBP Model measures, visit the Expanded Home Health Value-Based Purchasing Model [ https://links-2.govdelivery.com/CL0/https:%2F%2Flinks-2.govdelivery.com%2FCL0%2Fhttps:%252F%252Fwww.cms.gov%252Fpriorities%252Finnovation%252Finnovation-models%252Fexpanded-home-health-value-based-purchasing-model%2F1%2F0101019489ed6fae-7e206680-8453-4236-810d-3ae0f89bb442-000000%2FztN0OkC0u1vIPqpdYEUpxkuvdkBq32ykeTtk_uXSzE0=388/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/ANfuWO_4rTPs8Tj0O8QAVeXjLnHMuG5lLsI5SUPh4ug=399 ] webpage.

 

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*Getting Ready for the CY 2025 Measure Set – Available and Upcoming Resources*

As outlined in the CY 2024 Home Health (HH) Prospective Payment System (PPS) Final Rule [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.federalregister.gov%2Fdocuments%2F2023%2F11%2F13%2F2023-24455%2Fmedicare-program-calendar-year-cy-2024-home-health-hh-prospective-payment-system-rate-update-hh/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/lQeZj9mVXEWHCNupo4hcWJTtUr_B7VSSpctL2ZUDHxo=399 ], there are changes to the expanded HHVBP Model measure set starting with CY 2025 (referred to as the “CY 2025 measure set”). The October 2025 IPRs will be the first to generate Improvement, Achievement, and Care Points based on the CY 2025 measure set covering 12 months of performance data through June 30, 2025 for OASIS-based measures and through March 31, 2025 for claims-based and HHCAHPS Survey-based measures.

To help HHAs get ready for this change, CMS has started providing resources, including the following three worksheets in previous and upcoming IPRs, that provide a preview of HHAs’ performance on the CY 2025 measure set:


* *_“CY 2025 AT and BM” tab:_*
* Starting with the July 2024 IPRs, preliminary Achievement Thresholds (AT) and Benchmarks (BM) have been available to HHAs in each IPR. In the July 2025 IPRs, this tab will show final AT and BM.


* *_“CY 2025 Baseline” tab:_*
* The January 2025 IPRs reported on HHAs’ preliminary Improvement Thresholds for the CY 2025 measure set. In the July 2025 IPRs, this tab will show final Improvement Thresholds.


* *_“CY 2025 Performance” tab:_*
* In the July 2025 IPRs, CMS will include an additional worksheet that reports on the most current performance period available by measure category – in line with the reporting period used for the CY 2024 measure set. Because most measures are included in both the CY 2024 and CY 2025 measure set, this additional tab will only report on the measures that are new to the CY 2025 measure set (i.e., Home Health Within-Stay Potentially Preventable Hospitalization, Discharge to Community-Post Acute Care Discharge Function Score).

In the upcoming April 2025 and July 2025 IPRs, Achievement Points, Improvement Points, Care Points, and TPS will be based on the CY 2024 measure set:


* *_April 2025 IPRs:_*
* OASIS-based measure performance will be based on 12 months of data through December 31, 2024. Claims-based and HHCAHPS Survey-based measures will be based on 12 months of data through September 30, 2024.


* *_July 2025 IPRs:_*
* All measures will report on performance up to the end of CY 2024 – except the two OASIS-based measures that overlap with the measures that are included in the CY 2025 measure set (i.e., Improvement in Management of Oral Medications and Improvement in Dyspnea). These two OASIS-based measures will cover a 12-month performance period through March 31, 2025.

Starting with the October 2025 IPRs, Achievement Points, Improvement Points, Care Points, and TPS will be based on the CY 2025 measure set:


* *_October 2025 IPRs:_*
* The three worksheets covering performance data on the CY 2025 measure set that are listed above are removed from IPRs starting with the October 2025 IPRs when the CY 2025 measure set will be in place. This means that CY 2025 measure performance, improvement thresholds, and final AT and BM will be applied to calculate HHAs’ Total Performance Score (TPS) starting in October. The “TNC Change Reference” tab will also be removed starting in October because the TNC Change in Mobility and TNC Change in Self-Care measures are no longer included in the CY 2025 measure set.

Note that the CY 2025 Annual Performance Report (CY 2025 APR), published in August 2025, will cover measure performance based on CY 2024 data. Please also refer to the Expanded HHVBP Model Guide [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.cms.gov%2Fpriorities%2Finnovation%2Fmedia%2Fdocument%2Fhhvbp-exp-model-guide/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/eQWkCWVoZ8j4xL1iB1Wb4ZZCOZ-wC2v-DBKmgo2uIZw=399 ], Section 7.1 for additional information on reporting periods by measure category covered in the IPRs/APRs slated to be published through August 2025.

CMS has also made available resources and training materials that provide details on the CY 2025 measure set. These resources are:


* *_Final Rule:_ *
* CY 2024 Home Health Prospective Payment System (HH PPS) Final Rule [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.federalregister.gov%2Fpublic-inspection%2F2023-24455%2Fmedicare-program-calendar-year-2024-home-health-prospective-payment-system-rate-update-quality/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/KQ7nk7DcLnCLDxFbKSvre7fXQajEp7yy5OlijhjekEw=399 ]


* *_Web-based Training:_ *
* Expanded HHVBP Model Web-Based Training: Changes to the Applicable Measure Set Beginning in CY 2025 [ https://links-2.govdelivery.com/CL0/https:%2F%2Frainmakerssolutions.com%2Fpostacutecaretraining%2FExpandedHHVBPModel%2Findex.html/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/QFXqiINj5Bx9mo3pZcURC-nsfhTvT5EaacuFQo71BCQ=399 ]


* *_Quality Measures:_ *
* Discharge Function Score (DC Function) Quality Measure Overview (PDF) [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.cms.gov%2Ffiles%2Fdocument%2Fhhqrp-hhvbp-discharge-functionscoremeasure11-19-2024.pdf/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/wiRKODeOSR1-LJcWW6E-vfJ6Eriaj5he4YFJJJlTfn0=399 ]

* *_Webinar:_*
* Expanded HHVBP Model: Preparing for Calendar Year (CY) 2024 and CY 2025 – Recording [ https://links-2.govdelivery.com/CL0/https:%2F%2Fyoutu.be%2F9dWJdTd5hvw/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/nfiSjt723_Hry3xCV_PYiWBmM9EW_1xfm2Z-GjiCYtQ=399 ], Slides (PDF) [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.cms.gov%2Ffiles%2Fdocument%2Fhhvbp-exp-prep-cy24-cy25-slides.pdf/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/KNAB8vfrXHhIWCkfmXHNX0HSJqowN09dtc1NWKJzO-I=399 ], and CY 2025 Written Resource (PDF) [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.cms.gov%2Ffiles%2Fdocument%2Fhhvbp-exp-prep-cy25-written-resource.pdf/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/N-zogjQdutKcCfHkhvtip3xdeUP4o25vUtF6iIZ5bzY=399 ]

 

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*Help Desk Highlights*

Over the past quarter, most inquiries into the help desk were related to an HHA’s annual payment adjustment, including 1) whether HHAs will see their adjusted payment percentage (APP) on their remittance advice that the Medicare Administrative Contractor (MAC) provides to the HHA after the MAC pays the claim, and 2) whether their APP will be applied before or after the 2% sequestration adjustment. Here are the answers to those two questions:

*Will HHAs see their APP on their remittance advice provided by the MAC?*

As stated in Q5007.2 of the March 2025 Expanded HHVBP Model FAQs, the Annual Payment Percentage (APP) will NOT be separately identified on an agency’s remittance advice.

*Will the* *APP be applied before or after the 2% sequestration adjustment?*

As stated in the new Q5008 of the March 2025 HHVBP FAQs, applying the sequestration adjustment is the last and final step in processing a claim.

In addition, the help desk has received questions related to the display of performance year 2024 and performance 2025 data on the IPRs published in 2025.

*Will the IPRs continue to report 12 months of data for the measures that are being removed from the expanded HHVBP Model applicable measure set after CY 2024?*

The January, April, and July 2025 IPRs will continue to report 12 months of data for those measures that will no longer be included in the expanded HHVBP Model applicable measure set after CY 2024.

For the measures that are being removed, including the Total Normalized Composite (TNC) Change measures, the April and July 2025 IPRs will include the 12 months of CY 2024 performance data for the measures. 

For additional information about report timing related to IPRs through July 2025, please also refer to the Expanded HHVBP Model Guide [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.cms.gov%2Fpriorities%2Finnovation%2Fmedia%2Fdocument%2Fhhvbp-exp-model-guide/2/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/JGZ4FbYmBLX33ZuCuK2nWCbOBLPw-Uy4-sJz60gyCqk=399 ], Section 7 (“Performance Feedback Reports”).

Also of note, from the March 2025 Expanded HHVBP Model FAQs is Q3025. This FAQ highlights updated information regarding the HHA baseline year for the Discharge to Community - Post Acute Care (DTC-PAC) measure. Since the DTC-PAC measure is a two-year measure, the HHA baseline year for this measure is CY 2022 and CY2023. This means that only HHAs with a Medicare certification date before January 1, 2022 that have at least 20 home health stays in the two-year reporting period of January 1, 2022 through December 31, 2023 will have Improvement Thresholds calculated for this measure for the calendar year (CY) 2025 performance year.

 

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*HHVBP Resources*

The following new or updated resources are located on the expanded HHVBP Model webpage [ https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.cms.gov%2Fpriorities%2Finnovation%2Finnovation-models%2Fexpanded-home-health-value-based-purchasing-model/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/Wa-P4GMisIBXrRLqtWJLUF2Fuu3tFlFAehv9Rnoa2-M=399 ]:


* Expanded HHVBP Model Frequently Asked Questions (PDF)
* HHVBP Public Reporting Tip Sheet – Revised 2025 (PDF)
* HHVBP Model Newsletter March 2025 (PDF)
* Technical Specifications for the Total Normalized Composite Change Measures – January 2025 (PDF)
* Expanded HHVBP Model Technical Expert Panel Report (February 2025) (PDF)
* Expanded HHVBP Model Reports – Access Instructions (PDF)

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*Contact Us*

Please *do not reply to this email *- this is an unmonitored inbox. If you require assistance, use the following options:


* For program questions about the expanded HHVBP Model, contact the HHVBP Model Help Desk at HHVBPquestions@cms.hhs.gov.
* For support with registration for the Internet Quality Improvement and Evaluation System (iQIES [ https://links-2.govdelivery.com/CL0/https:%2F%2Fiqies.cms.gov%2F/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/l6v-JjyqeoXxz_s18pITFVEeSNEsM-K-Wp2V1DenZ70=399 ]_)_, please contact our *QIES/iQIES Service Center *by phone at *(800) 339-9313 *or by email at iqies@cms.hhs.gov. You may also refer to the iQIES Onboarding Guide posted to QTSO for registration support: https://qtso.cms.gov/software/iqies/reference-manuals [ https://links-2.govdelivery.com/CL0/https:%2F%2Fqtso.cms.gov%2Fsoftware%2Fiqies%2Freference-manuals/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/qRP-Sb5c2psil55t1dqSXFljSylD51svbuNGBhDlU2g=399 ]
* To receive email updates about the expanded Model, please subscribe to the Expanded HHVBP Model listserv [ https://links-2.govdelivery.com/CL0/https:%2F%2Fpublic.govdelivery.com%2Faccounts%2FUSCMS%2Fsubscriber%2Fnew%3Ftopic_id=USCMS_12825%2522%253EClick%2520to%2520subscribe%253C%2Fa%253E/1/01010195f876af59-95f0b3cb-c631-408e-bc32-3da7b4abddc8-000000/we6MExTJabz8SSsJx86yNsS03TOdOccKHqGritpP3ow=399 ]. Enter your email address in the contact form, then select “Home Health Value-Based Purchasing (HHVBP) Expanded Model” from the Innovations list.
* Please contact the *Home Health Quality Reporting Program (HH QRP) Help Desk *at homehealthqualityquestions@cms.hhs.gov for questions about the following: Home Health Quality, including Care Compare (excluding HHCAHPS), OASIS coding and OASIS documentation, quality reporting requirements & deadlines, data reported in quality reports, measure calculations, Quality of Patient Care Star Rating (excluding suppression requests), public reporting, risk adjustment, and Quality Assessment Only (QAO)/Pay for Reporting (P4P).
* Please contact the *Home Health CAHPS Help Desk* at hhcahps@rti.org for questions related to the HHCAHPS Survey or Patient Survey Star Ratings.





Center for Clinical Standards and Quality








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