Improving Home Health Care Quality: Focal Quality Improvement Project to Elevate Home Health Value-Based Purchasing (HHVBP) Oasis-Based Measures Impacting Patient Care Outcomes

The Home Health Value Based Purchasing (HHVBP) Model program was introduced in 2016 as a pilot through the Centers for Medicare and Medicaid Services (CMS). The program devised a formula to incentivize Medicare-Certified home health agencies in the United States (U.S) to improve patient care quality, reduce hospitalizations, and improve patient experiences. The original model was piloted in 9 states (Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee) from 2016 to 2021. These states represented geographical areas across the nation where Medicare-certified “payment was tied to quality performance.” Participating agencies’ performances were evaluated using the Outcome and Assessment Information Set (OASIS) instrument to extract data related to patient outcome measures and claim-based measures. Data extraction of patient experiences came from HHCAHPS surveys. Conclusions drawn from the first 3 years denoted modest improvements in OASIS-based quality measures in patients in HHVBP participating agencies versus non-participating agencies. Nationwide expansion of HHVBP began in 2022, with the first full performance year starting January 1, 2023. This quality improvement project examines a Michigan-based home health care organization’s implementation of a focused OASIS-based measures process to improve patient outcomes impacting their HHVBP Model TPS scores within their designated cohort. Analysis of the executed plan revealed strategic implementation of measures to improve OASIS-based measures had a positive impact on clinician engagement with patients to facilitate improved patient outcomes. Improvement outcomes positioned the agency to be rewarded with a positive payment adjustment incentive in 2026 based on their CY 2025 performance.