CMS Announces Early Release of Final HHVBP Annual Performance Reports Following Calculation Errors

In the November 6, 2024 CMS Open Door Forum, important updates were announced regarding the Home Health Value-Based Purchasing (HHVBP) program, specifically concerning the accuracy of Annual Performance Reports (APRs). CMS identified calculation errors in the Preview and Preliminary versions of the APR, related to claims-based measures, prompting corrective actions and an accelerated release of the Final APRs.

Key Highlights:

1. Calculation Errors Detected
   CMS confirmed that errors in the Preview and Preliminary APRs were due to missing data in risk adjustment for claims-based measures. The affected metrics include the Acute Care Hospitalization (ACH) and Emergency Department (ED) use measures. It’s important to note that the Potentially Preventable Hospitalization (PPH) measure was unaffected, as CMS verified there were no issues with its calculations.
2. Early Release of the Final APR
   Initially scheduled for release in early December, the Final APR will now be published this week. This expedited release gives home health agencies additional time to review and address any potential discrepancies arising from the previous calculation issues. Agencies will have a 15-day window from the release date to request a recalculation if necessary.

Note: Typically, recalculations are not permitted once the Final APRs are released. This exception is a one-time provision due to the recent calculation errors.

3. October Interim Performance Reports (IPRs) Delayed
   To minimize potential confusion, CMS has decided to delay the release of the October IPRs by two weeks, which were originally set for October 24. CMS emphasized that the decision to hold back these reports is intended to reduce overlap and ensure agencies can focus on the Final APRs without distraction.
4. CMS Assurance on Corrected Calculations
   CMS assured participants in the forum that they have thoroughly corrected the calculation errors and are confident in the accuracy of both the Final APR and the October IPRs once they are released. This confirmation provides reassurance to agencies that all necessary corrections have been addressed, particularly for ACH and ED use measures, allowing agencies to move forward with confidence in their reported performance metrics.

What This Means for Home Health Agencies:

The early release of the Final APRs and the extended window for recalculations present a valuable opportunity for agencies to carefully review their data and address any concerns before the recalculation deadline. Here are some action points for agencies to consider:

• Review APRs Promptly: Once the Final APRs are available, agencies should prioritize reviewing the corrected data to ensure it aligns with their internal records and expected outcomes.
• Assess Need for Recalculation: If any discrepancies are identified, agencies must act within the 15-day window to request a recalculation. This is a rare opportunity, as recalculations on Final APRs are generally not permitted.
• Meet with McBee Experts: McBee experts are here to help your agency understand your reports and determine if there is a need for a recalculation request. We can assist agencies in identifying strengths and weaknesses and help prepare your agency for improvement in both clinical and financial outcomes.

This proactive approach by CMS underscores its commitment to accuracy and transparency within the HHVBP program, helping agencies stay informed and well-equipped to address any issues that arise. With these adjustments, agencies can continue focusing on delivering quality care while navigating the value-based purchasing landscape with updated and precise performance data.

Looking Ahead

As CMS continues refining the HHVBP program, it’s essential for agencies to fully understand their performance data to strategically position themselves for success in 2025 and beyond. At McBee, we are committed to assisting agencies in navigating these updates, providing insights that go beyond just compliance. Our expertise in HHVBP reporting allows us to help agencies not only understand their results but also to leverage these insights to drive both clinical and financial outcomes.

To support our clients during this critical period, McBee is offering free consultations to review HHVBP reports. We encourage agencies to schedule a time to meet with us, where our team will walk through the reports, identify key areas of opportunity, and discuss strategies tailored to your agency’s unique needs. Our goal is to empower your team with actionable insights, ensuring you’re positioned for sustained success in the value-based care landscape.

About the Author

Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, VP of Education and Quality

Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, is the VP of Education & Quality at McBee, bringing over 35 years of expertise in home health and hospice. As a registered nurse and home care attorney, she specializes in regulatory compliance. Lisa has held various roles, from field nurse to executive, managing accreditation surveys, acquisitions, and regulatory crises. In 2004, she founded Selman-Holman & Associates, offering consulting, coding and OASIS review services. Lisa is a renowned educator, known for turning challenges into achievements. Joining McBee in 2021, she leads education initiatives at the Post-Acute Academy, providing courses for home health and hospice staff and executives, including clinical, regulatory and onboarding requirements.

About the Author

Michelle Horner, Manager of Clinical Consulting and Education

Michelle Horner, BSN, RN, HCS-O, HCS-D, HCS-H, COS-S is the Clinical Consulting and Education Manager for McBee. She has more than 30 years of experience in healthcare with an extensive background in critical care and home care. Michelle has been instrumental in the content creation for the McBee Post-Acute Academy. She currently specializes in Quality, Clinical, and Regulatory Consulting and Education. Michelle develops and provides custom on-site client education programs. She speaks regularly for various home care associations. Her expertise regularly appears in the Decision Health Diagnosis Coding Pro and she is a subject matter expert contributor for several Decision Health publications. Michelle currently serves on the AHCC’s Board of Medical Specialty Coding and Compliance Certification HCS-D and HCS-O Committees.