This regulation governs the Home Health Value-Based Purchasing (HHVBP) Model, specifying how CMS calculates and applies value-based payment adjustments to competing home health agencies based on their performance scores relative to baseline standards. It details the mathematical formulas for determining the payment adjustment amount and percentage, including use of the linear exchange function slope and Total Performance Score. This rule applies exclusively to home health agencies and does not govern any behavioral health, IDD, ABA, or foster care facility type.
View official source§ 484.330 Process for determining and applying the value-based payment adjustment under the Home Health Value-Based Purchasing (HHVBP) Model. (a) General. Competing home health agencies will be ranked within the larger-volume and smaller-volume cohorts in selected states based on the performance standards that apply to the HHVBP Model for the baseline year, and CMS will make value-based payment adjustments to the competing HHAs as specified in this section. (b) Calculation of the value-based payment adjustment amount. The value-based payment adjustment amount is calculated by multiplying the Home Health Prospective Payment final claim payment amount as calculated in accordance with § 484.205 by the payment adjustment percentage. (c) Calculation of the payment adjustment percentage. The payment adjustment percentage is calculated as the product of: The applicable percent as defined in § 484.320, the competing HHA's Total Performance Score divided by 100, and the linear exchange function slope.