January 5 2026
OASIS Answers
Categories: HHVBP

The Alphabet Soup of HHVBP: APP and TPS

by Lori A Marmon, PT, MBA, COS-C

From Acronyms to Clarity: HHVBP Basics Explained

In home healthcare, there are lots of acronyms thrown around that become part of our everyday language (SOC, CoP, etc.) and with the Home Health Value-Based Purchasing (HHVBP) Model now adding even more acronyms to the mix, it’s important to take a moment to make sure we understand what we are talking about when we use these abbreviations.

TPS, which stands for Total Performance Score, is an awarded score that an agency receives based on their performance on a group of quality measures that apply for the current performance year, the applicable measure set. If an agency has enough data for at least 5 of the measures in the measure set, then a TPS gets calculated from the agency’s “care points” in the performance year. Remember that care points are the higher of the achievement or improvement points an agency earns for each measure with enough data. The TPS is going to be a numeric score between 0-100.

APP, which stands for the Adjusted Payment Percentage, is the percentage amount that the payment for an agency’s Medicare-fee-for-service claim is adjusted in the payment year. The APP is going to be a numeric value between -5% and +5%.

Remember the performance year and the payment year are 2 different years. For example, an agency’s performance (measured by their TPS) in calendar year 2025 will impact their payment (using their APP) in calendar year 2027.

How TPS Drives Payment: Connecting Performance to Dollars

Looking at the simplest explanation, an agency’s APP depends on an agency’s TPS. Meaning the percentage of payment adjustment that an agency can expect is related to the agency’s performance on the quality measures in the applicable measure set that make up data used to calculate the TPS.

Agency’s that have a higher TPS (remember a numeric value between 0-100) compared to the average TPS of the other agencies in their cohort would expect a POSITIVE APP value (a percentage value up to +5%).

Agency’s that have a lower TPS compared to the average TPS of the other agencies in their cohort would expect a NEGATIVE APP value (a percentage value up to -5%).

Where Agencies Can Move the Needle

Knowing that an agency does not have control over the performance of other agencies, it makes sense to focus efforts on factors that an agency can influence. Directing energies toward understanding what measures make up the performance year’s applicable measure set and how those measures are determined allows an agency to take steps to impact their calculated performance score, the TPS.

For example, in 2025 there are three (3) measures in the applicable measure set that are based on OASIS coding responses. Ensuring that the assessing clinicians at your agency understand the intent and guidance for these OASIS items could create a positive impact on the calculation of your agency’s TPS.

The Expanded HHVBP Model terms will become an increasing part of our daily dialogue and having insight into what these terms mean and what actions an agency can take makes sense. When agencies can all speak the same home health care language, there can be more overall awareness and movement in a positive direction. OASIS Answers offers private training programs to agencies looking to get their whole team on the same page.

Consider the opportunity to have the OASIS experts bring the education to YOU, in your space (no travel expenses for your team!), where the whole team can collaboratively work together to optimize learning and application of OASIS accuracy! Learn more about bringing OASIS Answers directly to your door.