by Elaine Gardner, MS, RN, COS-C, CPHQ, CHPN
How is “Cohort” used in the expanded HHVBP Model?
The term “cohort” is used in the expanded HHVBP Model to describe the group in which an HHA competes with other HHAs within one of two nationwide volume-based groups (“cohorts”) on a set of quality measures related to the care provided. The two (2) volume-based cohorts are defined by the number of unique HHCAHPS Survey-eligible beneficiaries for each HHA in the year prior to the performance year.
The group of competing HHAs that had fewer than 60 unique HHCAHPS Survey-eligible beneficiaries in the calendar year prior to the performance year is the smaller-volume cohort. And the group of competing HHAs that had 60 or more unique HHCAHPS Survey-eligible beneficiaries in the calendar year prior to the performance year is the larger-volume cohort.
CMS believes that separating smaller and larger-volume home health agencies (HHAs) into cohorts under the expanded HHVBP Model groups HHAs that are of similar size and are more likely to receive scores on the same set of measures for purposes of setting benchmarks and achievement thresholds and determining payment adjustments.
To compare a competing HHA’s performance to the performance of other HHAs within the same cohort, a percentile ranking is provided in the expanded HHVBP Model performance reports.
How does an agency know their cohort assignment?
HHAs can identify their cohort assignment through the expanded HHVBP Model performance feedback reports available on iQIES. Updated cohort assignments will be recalculated annually and made available in the July Interim Performance Report (IPR).
The two cohorts for the CY 2023 performance year, and therefore the CY 2024 APR, were determined based on the number of unique HHCAHPS Survey-eligible beneficiaries in CY 2022. Looking ahead, for the CY 2024 performance year, the cohort assignment will be based on CY 2023 beneficiary counts. Because the beneficiary counts can change year to year, so can the cohort assignment.
The cohort assignment is updated every July based on the most recent full calendar year. For example, the cohort assignment was updated in July 2024 for the CY 2024 performance year based on the number of unique HHCAHPS Survey-eligible beneficiaries in CY 2023.
To learn more about cohorts and other aspects of calculations used in the expanded HHVBP Model, access the CMS resources provided on the CMS Expanded HHVBP Model webpage!
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