When comparing the first and second performance years of value-based purchasing, it appears home health agencies in value-based states improved about the same percentage as agencies that weren’t.
 
That’s according to data from Strategic Healthcare Programs (SHP) in Santa Barbara, Calif.
 
When comparing data from 2016 to 2017, agencies nationwide improved more than 3% on five value-based measures. Those measures are ambulation, bathing, dyspnea, pain and improvement in management of oral medications. (See data, below.)
 
Meanwhile, agencies achieved little improvement in HHCAHPS measures — and actually had scores decrease in some areas.
 
Note that with the exception of flu, pneumococcal polysaccharide vaccine (PPV) and the HHCAHPS composite 3 scores, value-based agencies had better outcomes than agencies in states without value-based purchasing.
 
Identify where to improve in VBP
 
When deciding what scores you want your value-based agency to target, it is best to know what percentile rank you want to realistically achieve.
 
The total performance score (TPS) in value-based purchasing uses percentile ranking to compare an agency’s scores to the competitors within the value-based state. The higher an agency’s TPS, the greater its likelihood to earn a bonus.
 
To receive achievement points in any given measure, scores must be higher than the 2015 calendar year median values. The higher the percentile rank, the greater the number of overall points an agency will earn.
 
For example, the median SHP score for ambulation in 2017 was 75.2%, slightly higher than the overall average of 74.9%. To be at the 75th percentile ranking, agencies would have needed a score of 79.8%.
 
Knowing that state and national scores will continue to improve, agencies will need to add a factor to their overall target. Ambulation improved 7.1% from 2015 to 2016 and 3.7% from 2016 to 2017, and they likely will improve again — as much as two to three percentage points in 2018.
 
Adding a reasonable factor is critical for measure goal setting and tracking progress. 
 
Editor’s note: Chris Attaya is vice president of product strategy for SHP. Read the full story at https://shpdata.com/blog/hhvbp-scores-to-shoot-for/.
 
 
 
Value-based states
Non-value-based states
Value-based measure
2017
2016
Percentage improvement
2017
2016
Percentage improvement
Ambulation
76.2%
72.5%
3.7%
74.7%
71.0%
3.7%
Bed transferring
73.0%
70.1%
2.9%
70.7%
67.9%
2.8%
Bathing
80.5%
77.3%
3.2%
78.2%
75.9%
2.3%
Dyspnea
80.0%
76.7%
3.3%
77.4%
74.2%
3.2%
Oral medication
66.4%
62.6%
3.8%
64.7%
61.4%
3.3%
Pain
80.5%
76.6%
3.9%
78.1%
74.9%
3.2%
Discharge to community
73.1%
72.8%
0.3%
71.3%
70.9%
0.4%
Flu
80.3%
79.4%
0.9%
81.5%
79.8%
1.7%
Drug education
98.7%
98.1%
0.6%
98.7%
97.9%
0.8%
PPV
82.6%
82.4%
0.2%
85.1%
83.8%
1.3%
Hospitalizations (+ improved)
15.5%
15.1%
-0.4%
15.6%
15.5%
-0.1%
Composite 1 (care of patients)
88.8%
88.8%
0.0%
88.5%
88.5%
0.0%
Composite 2 (communications)
86.2%
86.1%
0.1%
85.9%
86.0%
-0.1%
Composite 3 (specific care)
82.7%
82.7%
0.0%
83.1%
83.4%
-0.3%
Universal 1 (overall rating)
83.9%
84.0%
-0.1%
83.7%
83.8%
-0.1%
Universal 2 (recommend)
79.1%
79.4%
-0.3%
78.6%
78.9%
-0.3%