UnderstandingYour Starting Point

Before you can improve, you need to know where you stand. Your Interim Performance Report (IPR), available through iQIES, provides the clearest picture of your current performance across all HHVBP measures.

The IPR shows your scores foreach measure category: OASIS-based measures (functional improvement and outcomes), claims-based measures (hospitalizations and community discharge),and HHCAHPS survey measures (patient satisfaction). More importantly, it shows both your achievement score (how you compare to national benchmarks) and your improvement score (how you compare to your own baseline). Your final score foreach measure is whichever is higher, which means even agencies starting from a low baseline can earn strong scores by demonstrating improvement.

Key Questions to Answer from Your IPR

First, which measure category is dragging down your Total Performance Score? If your OASIS-based measures are strong but claims-based measures are weak, your improvement strategy should focus on hospitalization prevention rather than documentation accuracy.

Second, are you scoring higher on achievement or improvement for each measure? If improvement scores areconsistently higher, you started from a lower baseline and have momentum. If achievement scores are higher, you are performing well but may have limited room to show improvement.

Third, which specific measures show the biggest gap between your performance and the benchmark? These represent your highest-impact improvement opportunities.

OASIS-BasedMeasures: Where Accuracy Meets Outcomes

For 2026, the OASIS-based measures in HHVBP include the Discharge Function Score (based on GG items),Improvement in Dyspnea, and three newly added functional measures: Improvement in Bathing (M1830), Improvement in Upper Body Dressing (M1810), and Improvement in Lower Body Dressing (M1820).

These measures share a common challenge: they depend on accurate OASIS assessment at both start of care and discharge. If clinicians consistently over-score patients at admission (making them look more functional than they are) or under-score at discharge (missing improvements that occurred), your outcome measures will suffer regardless of the quality of care actually delivered.

ImmediateActions for OASIS Improvement

Start by auditing a sample of recent OASIS assessments, comparing start of care to discharge scores. Look for patterns: Are certain clinicians consistently scoring patients differently than others? Are improvements in function being captured at discharge, or are scores staying flat even when patients demonstrably improved?

Focus training on the specificM-items that drive your VBP measures. For the functional improvement measures, this means M1810 (upper body dressing), M1820 (lower body dressing), and M1830(bathing). Clinicians need to understand exactly what each score level means and how to accurately assess patient capability, not just what the patient reports, but what they can actually demonstrate.

Consider implementing OASIS scrubbing or quality review before submission. A second set of eyes on assessments can catch inconsistencies and ensure that documented scores match the clinical picture. This is especially valuable for discharge assessments, where capturing improvement is critical to your outcome measures.

Claims-Based Measures: Keeping Patients Out of the Hospital

The claims-based measures inHHVBP for 2026 include Potentially Preventable Hospitalizations (PPH),Discharge to Community (DTC-PAC), and the newly added Medicare Spending PerBeneficiary Post-Acute Care (MSPB-PAC).

Unlike the previous Acute CareHospitalization measure that only looked at the first 60 days, PPH evaluates hospitalizations throughout the entire home health stay. This is actually good news for agencies caring for complex patients, because PPH includes risk adjustment based on patient characteristics. Agencies that take on higher-acuity patients receive credit for that complexity in the scoring model.

ImmediateActions for Hospitalization Prevention

Identify your highest-risk patients proactively. CMS has made clear that functional ability, dyspnea management, and medication management are key drivers of hospitalization risk.Patients with CHF, COPD, diabetes, and multiple co-morbidities need the most intensive monitoring and intervention.

Implement or strengthen your after-hours triage protocols. Many preventable hospitalizations happen because patients or caregivers do not know what to do when symptoms change outside business hours. A robust triage system that can assess symptoms and dispatch nursing visits when needed can prevent unnecessary ED trips.

Address social determinants of health. Unmet social needs, including food insecurity, transportation barriers, and medication affordability, are significant drivers of preventable hospitalizations. Screening patients and connecting them with community resources can reduce avoidable acute care utilization.

Review your medication reconciliation processes. Medication errors and adverse drug events are among the most common causes of preventable hospitalizations. Ensure that admission nurses are thoroughly reconciling medications using the brown bag technique and that any discrepancies are communicated to prescribers immediately.

HHCAHPS Measures: Patient Experience Matters

The HHCAHPS survey measures are changing significantly in 2026. Beginning with the April 2026 sample month, a revised survey launches with three new questions and eight removed. As a result, three composite measures (Care of Patients, Communication BetweenProviders and Patients, and Specific Care Issues) are being removed from HHVBP.

For 2026, the remaining HHCAHPS measures in HHVBP are Overall Rating of Care and Willingness to Recommend theAgency. These two measures will each carry 10% weight in your Total PerformanceScore, for a combined 20% of your score (down from 30% previously).

Immediate Actions for Patient Satisfaction

Focus on the overall experience rather than individual touch points. The remaining measures ask patients to rate their overall care and whether they would recommend your agency. These holistic assessments reflect the cumulative experience across all interactions, from scheduling to clinical care to communication.

Train all staff on soft skills and communication. This includes not just clinicians but also office staff who handle scheduling, intake, and phone calls. Every interaction shapes the patient's perception of your agency. Common training topics should include how to set expectations, how to communicate delays or schedule changes, and how to respond when problems arise.

Close the loop on patient concerns. When patients or families raise issues during care, ensure those concerns are addressed and communicated back to the patient. Nothing damages satisfaction scores more than feeling unheard or dismissed.

Review your discharge process.The final impression often carries the most weight in patient surveys. Ensure that patients feel prepared for discharge, understand their ongoing care needs, and know who to contact if questions arise.

ConnectingQuality Data to Staff Education

The agencies that consistently improve their VBP scores share a common characteristic: they connect quality data directly to staff education. When patterns emerge in quality metrics, training follows quickly and targets the specific staff and competencies involved.

This connection rarely happens automatically. In most agencies, quality data lives in one system, analyzed by quality directors who may or may not have time to translate insights into education requests. Meanwhile, training happens on a separate track, often driven by compliance calendars rather than real-time performance needs. By the time a quality trend gets translated into training content, delivered to staff, and reflected in changed behavior, months have passed.

Building the Connection

Start by making quality data visible to frontline staff, not just leadership. Clinicians who can see how their documentation and care decisions affect agency metrics are more likely to change behavior than those who receive abstract feedback months later.

Create a fast path from quality insight to targeted education. When your IPR reveals a decline in functional improvement scores, you should not need to wait for the next quarterlyin-service to address it. Microlearning, delivered in 5-minute modules that clinicians can complete between visits, allows you to respond to quality trends in days rather than months.

Make education specific to the problem. Generic annual competencies do not move VBP scores. Training on how to accurately assess M1830 (bathing) delivered to the specific clinicians whose assessments show inconsistencies will have far more impact than organization-wide refreshers on OASIS documentation.

Preparing for the 2026 Measure Set Changes

The HHVBP measure set is evolving, and agencies that prepare now will have an advantage. For 2026, CMS has added four new measures: Medicare Spending Per Beneficiary Post-Acute Care(MSPB-PAC) and three functional improvement measures based on M1810, M1820, andM1830.

The MSPB-PAC measure deserves particular attention because it introduces cost efficiency into the VBP equation. This measure compares your agency's Medicare spending per episode(including costs up to 30 days after the episode ends) to the national median.Agencies that deliver high-quality care efficiently will score well; those with higher-than-average costs will see this reflected in their Total PerformanceScore.

What This Means for Your Agency

The addition of MSPB-PAC means that utilization patterns matter. Agencies that over-visit, order unnecessary supplies, or fail to discharge patients appropriately will see financial consequences beyond just the direct costs. However, the measure is risk-adjusted, so appropriate care for complex patients should not be penalized.

The three new functional improvement measures (bathing, upper body dressing, lower body dressing)complement the existing Discharge Function Score. Together, these measures now represent a significant portion of your OASIS-based score. Accurate assessment of these specific M-items at both SOC and discharge is critical.

The October 2026 InterimPerformance Report will be the first to calculate your Total Performance Scorebased on the new measure set. Between now and then, focus on building the competencies and processes that will drive success under the new measures.

Building a Quarterly Rhythm

VBP improvement is not a one-time project. The agencies that consistently perform well have built quality improvement into their operating rhythm, with regular review cycles and clear accountability.

A quarterly rhythm tied to IPR releases works well for most agencies. When each Interim Performance Report drops, schedule time to review results, identify the biggest opportunities, develop targeted improvement plans, and assign accountability. Then track progress through internal metrics until the next IPR confirms whether your interventions worked.

A Suggested Quarterly Cycle

In the first week after IPR release, review your scores with your quality and clinical leadership team.Identify the two or three measures with the biggest gap between current performance and benchmark, or the biggest decline from previous reports. These become your focus areas.

In weeks two and three, drill into root causes. For OASIS-based measures, audit recent assessments to identify documentation patterns. For claims-based measures, review hospitalizations to identify preventable events. For HHCAHPS, analyze survey comments and complaint logs. Develop specific improvement plans with assigned owners.

In weeks four through twelve, implement your improvement plans. Deliver targeted training. Monitor leading indicators. Adjust as needed. Document your QAPI activities, both for survey readiness and to demonstrate improvement to CMS.

When the next IPR releases, evaluate whether your interventions moved the needle. Celebrate wins. Learn from what did not work. Start the cycle again.

The Bottom Line

Every day, your agency is generating the data that will determine your VBP payment adjustment. The OASIS assessments filed this week, the hospitalizations avoided or not avoided, the patient experiences being created in homes across your service area. This data does not wait for your attention. It accumulates whether you are actively managing it or not.

Agencies that treat VBP as a quarterly reporting exercise will consistently underperform. Agencies that build quality improvement into their daily operations, connecting data to education to behavior change, will see their scores climb.

The strategies in this article are not complex. Understand your starting point through your IPR. Focus on the measures with the biggest improvement opportunity. Connect quality insights to targeted staff education. Build a quarterly rhythm of review and improvement.These fundamentals, executed consistently, will move your VBP scores.

HOP was built to help agencies make this connection between quality data and staff education. When your HHVBP measures reveal improvement opportunities, HOP Huddles deliver targeted microlearning to the clinicians who need it. When incidents and complaints surface patterns, HOP+A3 builds structured improvement plans. When new staff join your team, HOP Orientation ensures they understand how their daily work affects agency quality metrics. Because under VBP, quality is not just about patient outcomes. It is about your agency's financial future.