Now Is The Time To Consider Your Agency To Be In Full Blown Competition. Value Based Purchasing Puts It There.

June 9, 2023

For those of you who have been in home health for decades, the idea of competition between agencies revolved around how to get market share. You did marketing, developed relationships, maintained visibility in your communities and gave good care. With the nationwide expansion of Value Based Purchasing, competition has a whole new meaning to our industry. Let's look into the expansion.


CMS began the original VBP project in 9 states on January 1st, 2016. It had 3 basic reasons listed for the project:

  1. Provide incentives for better quality care with greater efficiency;
  2. Study new potential quality and efficiency measures for appropriateness in the home health setting; and
  3. Enhance the current public reporting process.

The goal was to show that quality scores could improve while there was a potential for significant savings to the Medicare program in dollars. The program showed that VBP did just that. CMS reports savings of $141 million annually with improvement of quality scores by 4.6% in those states originally involved. By this, it should be no surprise to our industry that CMS announced a nationwide expansion.


CMS started the pre-implementation this year and has offered education to agencies to prepare for the full implementation on January 1, 2023. Agencies will see that payment rates will change beginning in 2025 based upon the performance numbers in 2023. You can register for the next scheduled CMS training entitled Navigating Performance Feedback Reports: Interim Performance Report (IPR) and Annual Performance Report (APR) which is scheduled for August 25th at 2pm ET. CMS also has many of the pervious recordings of trainings available for you here, so you can utilize the education and sign up for the listserv associated with Home Health Value Based Purchasing.

The expanded Home Health Value Based Purchasing Model is set to base reimbursement on your performance in relation to other agencies like yours. It will look at certain quality measures each calendar year. Your OASIS, HHCAHPS surveys, and designated claims measures will calculate performance. An agency can expect between a -5% to 5% change in Medicare fee for service payments.


So, what all this means for your agency is that you are not just competing for market share but for maximum reimbursement too. Agencies that do not perform will be hit for another loss to overall dollars. This could mean a transition of agencies no longer looking to provide Medicare services. It will be anticipated that certain agencies will not do well in the HHVBP model and not survive. The good news is that agencies focused on quality measures and patient satisfaction will thrive in HHVBP. Agencies need to keep the focus on Oasis accuracy, acute care hospitalization, and ER visits without hospitalization.


Should you need consulting for your agency, Kenyon Homecare Consulting has senior level consultants with comprehensive knowledge and experience within the industry to help you navigate your clinical, operational, and financial needs. Call us today at 206-721-5091 or contact us online to see how we can help you succeed!

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controlling chronic diseases
By Ginny Kenyon April 25, 2026
In the rapidly evolving landscape of healthcare, the burden of care is increasingly shifting from clinical facilities to the home. As the population ages, the prevalence of chronic conditions—such as heart disease, diabetes, and respiratory disorders—has reached unprecedented levels. For home care agencies, the quality of service is no longer just about assistance with daily living; it is more and more defined by the clinical competencies and disease-specific knowledge of your field staff. Chronic disease education for home care staff is not a luxury, is a strategic necessity that directly impacts patient outcomes, caregiver confidence, and the business’s bottom line. 1. Enhancing Clinical Outcomes and Safety Home care staff are the "eyes and ears" of the healthcare system. When aides and clinicians are highly educated on chronic disease processes, they can identify subtle shifts in a patient's condition before they escalate into emergencies. · Early Intervention: An educated caregiver can recognize the early signs of fluid retention in a Congestive Heart Failure (CHF) patient or skin changes in a diabetic patient, allowing for proactive adjustments rather than reactive ER visits. · Medication Adherence: Understanding why a medication is prescribed for a specific chronic condition helps staff reinforce the importance of adherence to the patient, reducing the risk of complications. 2. Reducing Hospital Readmissions Hospital readmission rates are a primary metric for home health success. Chronic diseases are the leading cause of "revolving door" hospitalizations. By providing specialized education, agencies empower their staff to implement Evidence-Based Practices at the bedside. When staff can effectively manage symptoms and educate patients on self-care, the likelihood of a patient staying stable at home increases dramatically. This not only benefits the patient but also strengthens the agency’s reputation with referral sources like hospitals and physician groups. 3. Boosting Staff Confidence and Retention The home care industry faces significant challenges with staff turnover. Often, burnout is fueled by the stress of feeling unprepared for complex patient needs. Knowledge is Empowerment: When staff members receive robust training, they feel more confident in their roles. This professional growth fosters a sense of value and belonging within the organization, leading to higher job satisfaction and lower turnover rates. 4. Improving Documentation Accuracy In an era of increased regulatory scrutiny, clinical documentation must be precise. Education on chronic diseases ensures that staff members use the correct terminology and focus on the most relevant clinical indicators during their assessments. · OASIS Accuracy: For Medicare-certified agencies, a deep understanding of chronic conditions leads to more accurate OASIS scoring, which directly influences reimbursement and quality ratings. · Audit Readiness: Well-educated staff produce notes that clearly reflect the necessity of care, making the agency much more resilient during regulatory surveys or audits. 5. Bridging the Communication Gap Effective chronic disease management requires a multidisciplinary approach. A caregiver who understands the nuances of a disease can communicate more effectively with: · Physicians: Providing clear, clinical updates that help doctors make informed decisions. · Family Members: Offering clear explanations and peace of mind to stressed family caregivers. · The Internal Team: Ensuring a seamless transition of care and consistent messaging across all disciplines. Conclusion Investing in chronic disease education is an investment in the agency’s future. By elevating the knowledge of the frontline workforce, home care providers can transform from basic service agencies into high-value clinical partners. In the end, the goal is simple: providing the highest quality of life for patients in the comfort of their own homes, a goal that can only be met through a highly trained and knowledgeable staff. If you do not know where to get comprehensive education for Chronic diseases, contact Kenyon Homecare Consulting at gkenyon@kenyonhcc.com or call 206-721-5091. We are here to help
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