Early Effects of Home Health Value-Based Purchasing on Quality Star Ratings

Area of Science:

• Health Services Research
• Healthcare Policy
• Quality Improvement

Background:

• The Home Health Value-Based Purchasing Model (HHVBP) incentivizes home health agencies to improve quality and patient experience for higher Medicare reimbursements.
• Quality measures in HHVBP often overlap with those used for Home Health Agency (HHA) star ratings.
• The impact of HHVBP participation on HHAs' Centers for Medicare & Medicaid Services (CMS) star ratings remains unclear.

Purpose of the Study:

• To evaluate the effect of HHVBP participation on the quality of patient care and patient experience composite star ratings for home health agencies.
• To compare changes in star ratings between HHAs competing in HHVBP and those not participating.

Main Methods:

• Utilized publicly available data from the Centers for Medicare & Medicaid Services (CMS).
• Employed a difference-in-differences analysis to assess changes in star ratings over a 2-year period.
• Compared star ratings for agencies participating in HHVBP versus non-participating agencies.

Main Results:

• A small, statistically significant increase in quality of patient care star ratings was observed for agencies participating in HHVBP.
• No statistically significant effect was found on patient experience composite star ratings for HHAs in the HHVBP program.
• The findings suggest HHVBP may positively influence clinical quality but not patient experience ratings.

Conclusions:

• HHVBP participation is associated with modest improvements in the quality of patient care star ratings.
• The current HHVBP model does not appear to significantly enhance patient experience ratings.
• Further research may be needed to understand the differential impact of value-based purchasing on various quality domains in home health.