HHVBP’s Shift to PPH: What It Means for Home Health Agencies

The transition from Acute Care Hospitalization (ACH) and Emergency Department (ED) Use to Potentially Preventable Hospitalizations (PPH) under Home Health Value-Based Purchasing (HHVBP) has raised concerns for many home health agencies. However, while the measures have changed, the goal remains the same—keeping patients out of the hospital.

What’s Different About PPH?

• Unlike ACH and ED Use, which only evaluated the first 60 days of a home health episode, PPH considers the entire stay—whether it’s 30 days or 6 months.
• PPH includes its own risk adjustment model, which benefits agencies that take on higher-acuity patients. Those who previously felt penalized under ACH now receive risk adjustments based on:
  • Patient demographics
  • Care received during prior proximal hospitalization
  • Other care received within one year of stay

This is good news for agencies that care for high-acuity patients—those who felt penalized under ACH may now see fairer, risk-adjusted scores under PPH.

What Agencies Can Do Now

Some organizations assume there’s nothing they can do to control PPH, but there are actionable steps that can improve performance:

• Know Your Data – Identify trends and hospitalization risk factors.
• Engage Your Team – Make PPH reduction a shared agency-wide effort.
• Leverage OASIS-E1 – Many OASIS items predict hospitalization risk—use them to build a stronger plan of care.
• Focus on Key Outcomes – CMS has made it clear: Improving functional ability, dyspnea management, and medication management reduces hospitalization risk, which is why these measures impact both HHVBP and Star Ratings.
• Address Social Determinants of Health (SDoH) – Unmet social needs are a key driver of preventable hospitalizations. Agencies must screen and support patients accordingly.

Turn Challenges into Achievements with McBee

Navigating the shift from ACH and ED Use to PPH doesn’t have to be overwhelming. At McBee, we help agencies turn data into actionable strategies that enhance performance and patient outcomes.

Want to learn more?

• Schedule a free consultation with McBee experts to review your HHVBP reports and uncover opportunities for improvement
• Join us for our upcoming webinar: From Risk to Reward: Mastering PPH to Drive Home Health Success

Together, we can turn your biggest challenges into achievements!

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. With over 30 years of healthcare experience, Michelle Horner is a leading expert in home health and hospice. As Manager of Clinical Consulting & Education at McBee, she excels in Quality, Clinical, and Regulatory Consulting, designing innovative training programs that elevate care standards. A sought-after speaker at industry events, Michelle captivates audiences with her expertise and passion. She serves on the AHCC’s Board of Medical Specialty Coding and Compliance Certification HCS-D and HCS-O Committees, shaping industry standards. Renowned for driving impactful financial and clinical outcomes, Michelle is dedicated to advancing the quality of care in the home care sector.