CMS Special Open Door Forum: Designing A Home Health Value-Based Purchasing Program

The Centers for Medicare & Medicaid Services will host a Special Open Door Forum on designing a value-based purchasing program for home health agencies. The purpose of this forum is to solicit input from all parties interested in the development of the plan for implementing a VBP program in HHAs. The forum will take place on February 24, 2011, 1:30-3:00pm EST.

Section 3006 of the Affordable Care Act requires the Secretary of Health and Human Services to develop a plan to implement a value-based purchasing program for payments to home health agencies under the Medicare program. The Secretary must submit a report containing this plan to Congress not later than October 1, 2011. Currently, we are in the process of identifying and analyzing key components of an effective VBP program for home health care.

After a brief presentation by CMS on the statutory requirements and the goals and objectives for today’s call, we will open the phones to comments.

CMS is seeking stakeholder input on a number of topics defined in the statute including:

  1. The ongoing development, selection, and modification process for measures of quality and efficiency;
  2. The reporting, collection, and validation of quality data;
  3. The structure of value-based payment adjustments, including the determination of thresholds or improvements in quality, the size of such payments, and the sources of funding for the value-based bonus payments;
  4. Methods for the public disclosure of information on the performance of home health agencies; and
  5. Any other issues.

The following list provides additional questions and findings from a literature review of existing VBP programs that we are interested in getting feedback.

  1. Quality Measures. Which types of measures do you think should be used to measure agency performance under a VBP program?
  2. Measuring Performance. What are the advantages and disadvantages of using individual measure scores or composite scores?
  3. Ranking Performance. Should performance incentives be based on attainment, improvement, improvement with an attainment floor or a combination?
  4. Payment Mechanisms. What factors should be considered in deciding how to reward incentive payments (e.g., payment frequency could be yearly, quarterly, or more frequent) and to collect penalties (e.g., withholding a percentage of all payments and distributing accumulated funds to high performers would eliminate the need to collect payments from poor-performing agencies)? What do you think is an appropriate payment level to promote high-quality care, without introducing excessive uncertainty about revenue?
  5. Data Infrastructure. What do you think are the most pressing concerns in the current data collection system for home health care? What can be done to reduce the burden of data collection, and ensure timely and accurate data submission?
  6. Public Reporting. How can public reporting complement a VBP program?

You are also encouraged to submit additional thoughts or feedback following the session via email by clicking here.

Special Open Door Forum Participation Instructions:

Dial 1-800-837-1935

Conference ID 37941789

Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and a Relay Communications Assistant will help.

An audio recording and transcript of this Special Forum will be posted to the Special Open Door Forum website and will be accessible for downloading beginning on or around March 24, 2011.

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