Home Health Groups Push Back Against Value-Based Purchasing Bill

Major home health provider groups have penned a letter opposing a value-based purchasing bill.

The National Association for Home Care & Hospice (NAHC) and other members of the post-acute care community wrote the letter to Kevin Brady (R-TX), chairman of House Ways & Means, Pat Tiberi (R-OH), chairman of the Health Subcommittee and Congressman Ron Kind (D-WI). The letter shares their thoughts on changes that they believe should be made to the Medicare Post-Acute Care Value-Based Purchasing Act of 2015.

The current legislation proposes that there be 5% of Medicare payments withheld and redistributed to post-acute providers based on a set of certain value-based purchasing criteria, such as quality measures. The letter suggests that the percentage be decreased to 2%.


The 2% figure was decided upon to keep the rate consistent with that of both the skilled nursing and hospital value based purchasing (VBP) systems. The percentage ought to be 1% in the first year and then increase by one-quarter of a percent to ultimately get to the 2% in the fifth year, according to the letter.

Another recommendation brought up in the letter relates to VBP scores. The authors say it should be focused primarily on patient outcomes, not resource use. Specifically, no more than 10% of a provider’s score should be based on resources they use.

Also, no VBP provisions should be set in stone until the outcomes measures are implemented and the public is able to start seeing results from the Medicare Post-Acute Transformation (IMPACT) Act of 2014, the letter says. The IMPACT Act called for standardized quality measures across post-acute settings, which ultimately could be used to revamp the way these different types of providers are paid for similar services. The legislators behind the VBP bill introduced last year described it as the “next iteration” of the IMPACT Act.


Already, CMS has launched a mandatory VBP program for home health in nine states.

Other organizations who signed the letter include: the American Health Care Association, the American Medical Rehabilitation Providers Association, LeadingAge and the Visiting Nurse Associations of America (VNAA).

See the full text of the letter.

Written by Alana Stramowski

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