42 CFR 484.370 - Process for determining and applying the value-based payment adjustment under the Expanded Home Health Value-Based Purchasing (HHVBP) Model.

Regulations last checked for updates: Nov 25, 2024

Title 42 - Public Health last revised: Nov 19, 2024

View all text of Subpart F [§ 484.300 - § 484.375]

§ 484.370 - Process for determining and applying the value-based payment adjustment under the Expanded Home Health Value-Based Purchasing (HHVBP) Model.

(a) General. Competing home health agencies are ranked within the larger-volume and smaller-volume cohorts nationwide based on the performance standards in this part that apply to the expanded HHVBP Model, and CMS makes value-based payment adjustments to the competing HHAs as specified in this section.

(b) Calculation of the value-based payment adjustment amount. The value-based payment adjustment amount is calculated by multiplying the home health prospective payment final claim payment amount as calculated in accordance with § 484.205 by the payment adjustment percentage.

(c) Calculation of the payment adjustment percentage. The payment adjustment percentage is calculated as the product of all of the following:

(1) The applicable percent as defined in § 484.345.

(2) The competing HHA's Total Performance Score divided by 100.

(3) The linear exchange function slope.

[86 FR 62422, Nov. 9, 2021, as amended at 87 FR 66887, Nov. 4, 2022]

authority: 42 U.S.C. 1302 and 1395hh

source: 54 FR 33367, Aug. 14, 1989, unless otherwise noted.

cite as: 42 CFR 484.370