In November 2015, CMS randomly selected 9 states from 9 regions to participate in the HHVBP. The program started on January 2016 and lasts through December 2020 for Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee.
To select the participants, CMS first divided states into 9 regions based on a variety of characteristics, including geographic proximity, home health utilization rates, ownership model of agencies, the proportion of home health users that are Medicare-Medicaid dually eligible beneficiaries, and average episodes of care per agency. Next, CMS used a random number generator to select one state within each of the 9 regions to be treated.
Agencies that meet the program’s inclusion criteria within the 9 treatment states face mandatory participation. There are two inclusion criteria. First, only agencies that were Medicare certified in the baseline year (2015) and in the performance year (2016) are included. Second, agencies must have at least 5 measures that meet minimum denominator case requirements (e.g., 20 episodes for quality measures and 40 HHCAHPS surveys) in both the baseline and performance periods. Agencies that do not meet these inclusion criteria do not compete for incentive payments.