More than 4 million people in the United States use home health care each year, but the quality varies and is often poor. In 2016, the Centers for Medicare & Medicaid Services (CMS) began rewarding and penalizing home health agencies for their performance on a set of predetermined quality measures in an experiment called the Home Health Value-Based Purchasing (HHVBP) program. This brief summarizes the results of a recent study evaluating the program’s impact on quality measures within the HHVBP and whether there was a relationship between incentive size and apparent quality. Findings suggest that while financial rewards improved the quality of care, some of the improvements may be related to data manipulation by the home health agencies.

Document Type

Research Brief


Healthcare Policy, Value Based Purchasing, Medicaid, Medicare


Health Policy | Public Affairs, Public Policy and Public Administration






Li is an affiliate of the Center for Aging and Policy Studies, which receives funding from the National Institute on Aging (grant # 1P30AG066583). The study was supported by the Agency for Healthcare Research and Quality (grant # R36-HS026836). The authors also thank Shannon Monnat and Alexandra Punch for edits on an earlier version of this brief.


National Institute on Aging, Agency for Healthcare Research and Quality

Funding ID

# 1P30AG066583, # R36-HS026836

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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