TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Adoption of Medicare's Home Health Value-Based Purchasing (HHVBP) Adjustments for Reimbursement Under TRICARE's Home Health Prospective Payment System Demonstration

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This notice describes the adoption of Medicare's Home Health Value-Based Purchasing (HHVBP) adjustments for reimbursement under TRICARE's Home Health Prospective Payment System (HH PPS). In recognition that the Defense Health Agency (DHA) strongly supports the implementation of value-based incentive programs, in accordance with Section 705(a) of National Defense Authorization Act (NDAA) for Fiscal Year 2017, the adoption of this model establishes a new value-based initiative within the TRICARE program, based on Medicare's similar pilot. In the Medicare HHVBP model, the Centers for Medicare and Medicaid Services (CMS) determines a payment adjustment up to the maximum percentage, upward or downward, based on the Home Health Agency's (HHA) Total Performance Score (TPS). As a result, the model incentivizes quality improvements and encourages efficiency. States selected for participation in the Medicare HHVBP model include Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, and Washington. CMS cannot release HHVBP adjustment factors to TRICARE, so Home Health Agencies (HHAs) in the participating states will be required to send their annual payment adjus