Open AccessThe Effects of Home Health Value-Based Purchasing on Home Health Care Quality in For-Profit and Nonprofit Agencies: A Comparative Interrupted Time-Series Analysis, 2012–2018
Author(s) -
U.G.E. Perera,
Andrew W. Dick,
Ashley M. Chastain,
Patricia W. Stone,
Jingjing Shang
Publication year - 2021
Publication title -
medical care research and review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.433
H-Index - 85
eISSN - 1552-6801
pISSN - 1077-5587
DOI - 10.1177/10775587211049628
Subject(s) - home health , purchasing , health care , business , long term care , medicine , nursing , marketing , economics , economic growth
Beginning in 2016, the Home Health Value-Based Purchasing (HHVBP) model incentivized U.S. Medicare-certified home health agencies (HHAs) in nine states to improve quality of patient care and patient experience. Here, we quantified HHVBP effects upon quality over time (2012-2018) by HHA ownership (i.e., for-profit vs. nonprofit) using a comparative interrupted time-series design. Our outcome measures were Care Quality and Patient Experience indices composed of 10 quality of patient care measures and five patient experience measures, respectively. Overall, 17.7% of HHAs participated in the HHVBP model of which 81.4% were for-profit ownership. Each year after implementation, HHVBP was associated with a 1.59 ( p < .001) percentage point increase in the Care Quality index among for-profit HHAs and a 0.71 ( p = .024) percentage point increase in the Patient Experience index among nonprofits. The differences of quality improvement under the HHVBP model by ownership indicate variations in HHA leadership responses to HHVBP.