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Navigating the Next Frontier of Value-Based Payments – Home Care

An Examination of the Future of Value-Based Payments in Home Care


May 17, 2023 – In the ever-evolving world of healthcare, change is constant, and the home care industry is no exception. With the recent expansion of the Home Health Value-Based Purchasing (HHVBP) Model, it’s clear that the winds of change are blowing in a new direction – one that prioritizes quality of care and improved health outcomes for patients. This paradigm shift is not only transforming the home health landscape but also paving the way for a similar revolution in the home care industry.

The road to embracing value-based payments in home care will be filled with both opportunities and challenges. Keep reading as we dive into how value-based payments are set to creep into the home care industry and what that means for consumers. 

Home Health VBP Model Expansion

First up, let’s talk about the Expanded Home Health VBP Model. This model tweaked the original HHVBP Model. Initiated by the Centers for Medicare & Medicaid Services (CMS), its main objective is to shift the focus towards the quality of care and achieving superior health outcomes. This is a game changer because it means rewarding home health agencies that deliver high-quality, efficient care. This nudges them towards constant improvement and is a patient-centric model, designed to ensure that the care process revolves around the needs of patients. 

The HHVBP model has seen some solid results, which is why CMS announced that it was being expanded nationwide. Based on prior years’ data, a research and consulting firm estimated that a nationwide HHVBP model could result in $6.3 billion in savings over 10 years, while also leading to better care outcomes from Medicare beneficiaries under the program. We’re currently in Year 1 of the nationwide expansion of the HHVBP and keeping close tabs on how providers and consumers are faring.

Home Health VBP Model a Precursor to VBP in Home Care

So, how does this impact the home care industry? While the Expanded Home Health VBP Model does not apply to non-medical home care, it provides insight into how a similar model might impact the home care industry. The HHVBP model encourages agencies to prioritize patient outcomes and invest in activities that enhance quality. By changing the focus from the quantity of services to the quality of those services, we can expect to see improved patient care, enhanced health outcomes, and ultimately, a more effective healthcare system. It’s proven successful in the home health industry, so home care is the next logical step. 

Simply put, home care is a good fit for value-based payments and the next logical step. Home care is inherently personalized and patient-centered, and these characteristics align seamlessly with a value-based approach. When care is provided in the familiar surroundings of one’s own home, tailored to individual needs, it has the potential to bring about significant improvements in health and well-being.

What To Consider When Implementing VBP Models in Home Care

Shifting to value-based payments in home care cannot happen without careful thought on things like social determinants of health and care coordination. 

Considering social determinants of health is essential because these non-medical factors such as housing, diet and nutrition, and access to the community, have a profound impact on health outcomes. To make the most of the value-based approach, these elements must be integrated into care strategies.

The selection of quality measures is another critical piece of the puzzle that needs careful consideration. The measures chosen should accurately represent the quality of care and the health outcomes achieved. This requires a delicate balance between clinical measures, patient-reported outcomes, and measures that reflect the broader influence of care on patients’ lives. Drawing inspiration from the Consumer Assessment of Healthcare Providers and Systems Home Health Care Survey (HHCAHPS) could be a good way to measure the experience of people receiving home care services. 

And then, we have care coordination – the essential cog in the value-based payment machine. Effective coordination ensures that all components of a patient’s care plan mesh together to deliver optimal results. This is especially crucial in the home care setting, where patients may interact with a variety of providers.

The Future of Home Care with Value-Based Payments

But, what does all of this mean for the future? Well, the journey towards value-based payments in home care will no doubt bring about new opportunities and challenges, but with a united focus on patient-centric care, the industry is well-equipped to tackle these obstacles head-on.

As we move forward, the home care industry will need to embrace innovation, invest in technology, and adapt to an ever-evolving health care landscape. This will include the adoption of tools and systems that enable better care coordination, real-time data sharing, and improved communication among providers. Additionally, it will be crucial for home care agencies to invest in staff education and training, ensuring that care providers are well-prepared to meet the unique needs of their patients.

That is exactly what Fady Sahhar, PhD, President, XtraGlobex, Inc., will be talking about at the Pennsylvania Homecare Association 2023 Annual Conference this week. His session will align the progress made in Pennsylvania with similar VBP programs across the country and examine how the providers can prepare for the future. As the homecare industry is primed to be the next frontier of VBP, it is important for homecare agency leaders to be prepared and have the proper tools and applications for improved consumer health and wellbeing, increased satisfaction, and better retention under VPB models. 

Advocates Perspective

The journey towards value-based payments in home care is an exciting and necessary step forward for the industry. By focusing on quality care and health outcomes and addressing key factors such as social determinants of health and care coordination, the home care industry can see significant benefit from implementing VPB models. The shift towards value-based payments in home care also presents a unique opportunity for collaboration among stakeholders, including home care agencies, health systems, payers, and community organizations. By working together, these stakeholders can identify best practices, share resources, and develop innovative strategies to address the complex needs of patients in the home care setting to create a system that delivers exceptional care, improves patient outcomes, and advances the overall health and well-being of our communities.


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About the Author

Fady Sahhar brings over 30 years of senior management experience working with major multinational companies including Sara Lee, Mobil Oil, Tenneco Packaging, Pactiv, Progressive Insurance, Transitions Optical, PPG Industries and Essilor (France).

His corporate responsibilities included new product development, strategic planning, marketing management, and global sales. He has developed a number of global communications networks, launched products in over 45 countries, and managed a number of branded patented products.

mandy sahhar

About the Co-Author

Mandy Sahhar provides experience in digital marketing, event management, and business development. Her background has allowed her to get in on the ground floor of marketing efforts including website design, content marketing, and trade show planning. Through her modern approach, she focuses on bringing businesses into the new digital age of marketing through unique approaches and focused content creation. With a passion for communications, she can bring a fresh perspective to an ever-changing industry. Mandy has an MBA with a marketing concentration from Canisius College.