Industry Insights

Under Medicare’s Patient-Driven Groupings Model (PDGM), the clinical characteristics of each Home Health patient help determine reimbursement for each 30-day period of care. Those characteristics are summarized through the HIPPS code, which places each period into a case-mix group and ultimately helps determine the Medicare payment. Understanding the HIPPS Code Under PDGM, each 30-day period is classified based on five key components reflected in the HIPPS code: • Position 1

As mentioned in another post, Service & Spending Variation Index (SSVI): A New Window on Hospice Performance, SSVI is a new hospice claims-based measure intended to identify hospice agencies whose care utilization patterns and non-hospice Medicare spending differ from national norms. Your data is already out there and available, and can be found here: We Make It Easy and Give you Meaningful Context Berg Data Solutions makes understanding your performance easy. We'll break do

As CMS rolls out the 2026 updates to the Home Health CAHPS (HHCAHPS) survey, one message is clear: the redesigned survey places greater emphasis on patient-centered care, emotional connection, and family involvement. At the same time, the Home Health Value-Based Purchasing (HHVBP) model is narrowing its lens. In 2026, only two patient experience measures will directly impact performance: Overall rating of care Willingness to recommend Together, these measures now account fo

For many home health leaders, Medicare Spending per Beneficiary (MSPB) has been an overlooked quality measure. Although it has appeared on CMS Care Compare for years, 2026 marks the first year that MSPB directly impacts Home Health Value-Based Purchasing (HHVBP) payment adjustments, making it a financial as well as a quality metric. Unlike traditional measures that focus on outcomes during the home health episode, MSPB evaluates the total Medicare spending associated with a p

CMS has introduced a new way to evaluate hospice providers by analyzing claims data for patterns that may suggest unusual utilization or Medicare spending. The Hospice Service & Spending Variation Index (SSVI) identifies hospices whose care patterns and non-hospice Medicare spending differ from national norms. While SSVI is not a payment program or quality rating, it reflects CMS's growing emphasis on program integrity, consistency, and responsible stewardship of Medicare res