How Home Health Agencies Can Adapt To TEAM and HHVBP Models

Home Health Agencies / By Audrie Martin

The landscape of home health care is evolving through the introduction of two key models designed to improve patient outcomes and reduce costs: the expanded Home Health Value-Based Purchasing (HHVBP) model and the Targeted Episode-Based Medicare Access and Payment (TEAM) model.

These initiatives incentivize home health agencies to provide high-quality, coordinated care while addressing the challenges associated with insufficient treatment for chronic health conditions. Ultimately, they aim to create a more efficient health care system for Medicare beneficiaries.

The primary model currently impacting home health providers is the expanded HHVBP model, according to ATI Advisory. This model adjusts Medicare payments based on a home health agency’s (HHA) performance on quality measures compared to their peers, rewarding agencies that deliver high-quality care.

In a fee-for-service health system, Medicare beneficiaries who qualify for home health care often receive inadequate and uncoordinated care for their chronic health conditions, according to ATI Advisory. This situation leads to increased emergency department (ED) visits, hospital admissions or placements in skilled nursing facilities (SNFs).

How the expanded HHVBP model affects HHAs

The expanded HHVBP model aims to improve the quality and efficiency of home health care. It was implemented on Jan. 1, 2022, and includes Medicare-certified HHAs in all 50 states, the District of Columbia and U.S. territories. The calendar year 2022 served as a pre-implementation year during which CMS provided HHAs with resources and training. The first full performance year was 2023, and the calendar year 2025 is the first year for payment adjustments based on performance in 2023.

The expanded HHVBP model builds on the success of the original model, which improved total performance scores among home health agencies by an average of 4.6%, according to the Center for Medicare and Medicaid Services (CMS). The original model also decreased unnecessary ED visits, improved patient mobility and reduced Medicare spending by $141 million…

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Health Programs on the GOP Chopping Block

Politico / By Chelsea Cirruzzo
 
Driving The Day
Many GOP lawmakers want to let ACA health insurance plan subsidies expire, but GOP Sen. Lisa Murkowski feels differently. | Francis Chung/POLITICO
 
GOP FLOATS HEALTH CARE CUTS — House Republicans are circulating a menu of options amounting to more than $5 trillion in cuts they could use to bankroll President-elect Donald Trump’s top priorities this year.
 
On the table: changes to Medicare, Medicaid and the Affordable Care Act. The list from the House Budget Committee could be used to finance a party-line reconciliation bill or other spending reduction efforts. The proposed cuts are highly ambitious, but not all are likely to become law, given the narrow margins for Republicans in the House and Senate.
I caught up with POLITICO Congress reporter and former Pulse author Ben Leonard to discuss the state of play.
 
There would be a few different ways on this “menu” to cut Medicaid. Can you walk us through them? 
 
One big target is per-capita caps, favored by House Energy and Commerce Chair Brett Guthrie (R-Ky.). They’d allocate a set amount of Medicaid funding based on population instead of being an open-ended entitlement. That’s projected to save up to $918 billion.
Another major target is equalizing payments for nondisabled adults with those of traditional Medicaid enrollment — those with disabilities or low-income children, which [Republicans] say would save up to $690 billion.
 
Adding work requirements in the program is also on the table and is pegged to save $120 billion.
 
Which ones would get the most opposition from Dems?
 
They’d pretty much all be nonstarters for Democrats and even some Republicans. Medicaid insures more than 70 million Americans, and any legislation that might reduce coverage in the program would be fiercely opposed by Democrats and could be a tough vote for Republicans in swing districts.
 
The proposed ACA changes involve enhanced premium tax credits that expire at the end of the year, setting up a major policy battle. 
 
Democrats broadly support extending the enhanced subsidies, which have lowered premium costs for many Americans and led to record ACA marketplace enrollment. Many Republicans support letting them expire, arguing they’re raising health care costs, but moderate Sen. Lisa Murkowski (R-Alaska) recently said she supports extending them. Either way, Republicans will have a difficult choice: spend hundreds of billions to buoy Obamacare enrollment or raise premium costs significantly heading into an election year in 2026.
 
Are there any proposals that could get bipartisan agreement?
 
Site-neutral payments are a more bipartisan option under consideration. Limiting eligibility for ACA plans based on citizenship status could receive more bipartisan interest than it might have previously, given Democrats’ pivot on immigration after a tough election cycle. But most of the options are not expected to receive much, if any, Democratic support…

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ACO Growth Inches CMS Toward Value-Based Care Goal

Modern Healthcare / By Bridget Early
 
More than half of fee-for-service Medicare enrollees are now in accountable care arrangements, putting the Centers for Medicare and Medicaid Services past midway toward its 2030 goal, according to data the agency released Wednesday.
Accountable care participation rose 4.3% to 14.8 million people from 2024 to 2025, the largest annual increase since CMS started tracking these numbers. That amounts to 53.4% of fee-for-service beneficiaries, according to the agency.
 
The CMS report illustrates the progress the agency has made promoting value-based care in traditional Medicare since announcing in 2021 that it wanted all fee-for-service enrollees in accountable care arrangements by 2030. It also shows how much is left to do to meet that target, and consummating the endeavor would require President-elect Donald Trump's administration to pick up where President Joe Biden's team leaves off.
 
“This progress demonstrates that when providers are empowered to manage costs and focus on outcomes, they can achieve high-quality outcomes and drive innovation,” Aisha Pittman, senior vice president of government affairs for the National Association of ACOs, said in a news release.
 
Tweaks to existing accountable care organizations and the creation of models such as the ACO Primary Care Flex Model support the 2030 goal, but regression in one high-profile model highlights the ongoing challenges. Congress also must decide how to handle bonus payments for providers transitioning into value-based care.
 
The CMS report covers the permanent Medicare Shared Savings Program and models from the Center for Medicare and Medicaid Innovation such as ACO Realizing Equity, Access and Community Health, or ACO REACH…

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Mandatory OSHA Injury & Illness Reporting

Alliance Daily

Many employers with more than 10 employees are required to keep a record of serious work-related injuries and illnesses. Some health care and home care companies must electronically submit injury and illness reports to the Occupational Safety & Health Administration (OSHA) annually through OSHA’s Injury Tracking Application (ITA).  The deadline for submission of the 2024 data is March 2, 2025.

It is important to note OSHA has requirements for both recording and reporting work-related injuries and illnesses. A recordable injury or illness includes:

• Any work-related fatality.
• Any work-related injury or illness that results in loss of consciousness, days away from work, restricted work, or transfer to another job.
• Any work-related injury or illness requiring medical treatment beyond first aid.
• Any work-related diagnosed case of cancer, chronic irreversible diseases, fractured or cracked bones or teeth, and punctured eardrums.
• There are also special recording criteria for work-related cases involving: needlesticks and sharps injuries; medical removal; hearing loss; and tuberculosis.

To determine if your organization must submit a report, please review the ITA submission requirement flowchart [found on page 3 of the linked Injury Tracking Application (ITA) User Guide] Note that there may be different and/or additional state-specific reporting differences.

All employers, including those partially exempted by reason of company size or industry classification, must report to OSHA any workplace incident that results in a fatality, in-patient hospitalization, amputation, or loss of an eye (see § 1904.39). 

Additional information about OSHA’s recordkeeping and reporting requirements can be found here.