From Report to Action: How to Use Your IPR to Improve HHVBP Scores

A Practical Guide to Turning Insights into Quality Improvement Initiatives

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Home health agencies participating in the Home Health Value-Based Purchasing (HHVBP) Model know the stakes are higher than ever. With financial incentives and penalties directly tied to performance, understanding how to improve your scores is not just good practice—it’s a business necessity. One of the most underutilized tools for quality improvement is the Interim Performance Report (IPR).

Released quarterly by CMS, the IPR contains a goldmine of data. Yet many agencies struggle to translate its insights into concrete action. This blog will guide you step-by-step through how to decode your IPR and use it to drive meaningful, measurable improvements in HHVBP performance.

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Understanding the IPR: What’s in the Report?

Before diving into action, let’s break down what the IPR actually includes. The IPR is your agency’s performance dashboard under HHVBP, showing how you’re doing relative to peers on a variety of metrics. These reports include:

• Your performance scores (both raw and risk-adjusted)

• Improvement scores (how much you’ve improved year-over-year)

• Achievement points (comparison to peers)

• Total performance score (TPS)

• Payment adjustment estimates

Metrics are drawn from several key domains:

• OASIS-based Measures (e.g., Improvement in Ambulation, Self-care)

• Claims-based Measures (e.g., Hospitalization, Emergency Department Use)

• HHCAHPS Survey Measures (patient experience data)

Understanding how each measure contributes to your Total Performance Score (TPS) is the first step in targeting improvement efforts.

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Step 1: Assemble Your IPR Taskforce

Using the IPR effectively requires collaboration. Assemble a small, agile team to analyze and act on IPR findings. This team should include:

• Clinical leadership (Director of Nursing, QA/QI Manager)

• Data or analytics staff

• Frontline clinicians (or their representatives)

• Patient experience or HHCAHPS coordinator

Empower the team to own the process—from reviewing the report to implementing improvement plans.

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Step 2: Identify Your Performance Gaps

Now, dive into your IPR. Your goal is to identify the biggest opportunities for improvement. Start with these questions:

1. Which measures have the lowest scores?
   Focus on both absolute performance and areas where improvement scores are low.

2. Are there negative trends?
   Look at year-over-year data to spot declining performance.

3. How do we compare to peers?
   CMS reports include national percentiles. If you’re below the 50th percentile on a measure, you’re underperforming relative to peers.

4. Which measures impact our TPS the most?
   Some measures are weighted more heavily in the TPS calculation. Targeting those can yield bigger returns.

✅ Tip: Create a table or dashboard that categorizes measures into “high priority,” “moderate priority,” and “low priority” based on these factors.

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Step 3: Translate Insights into SMART Goals

Once you’ve zeroed in on target measures, turn those into SMART goals:

• Specific: Target a specific metric or behavior

• Measurable: Quantify what success looks like

• Achievable: Be realistic given your resources

• Relevant: Tied directly to your HHVBP score

• Time-bound: Set a deadline for results

Example:

• Problem: OASIS measure for “Improvement in Ambulation” is at the 40th percentile

• SMART Goal: Increase “Improvement in Ambulation” score by 10% within the next 6 months through standardized gait training protocols

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Step 4: Align Improvement Projects to IPR Findings

Now, build Quality Improvement (QI) initiatives that align with the metrics you’re targeting. Here’s how to turn insights into action across HHVBP domains:

1. OASIS-Based Measures

These measures reflect functional improvements documented by clinicians. Common challenges include inconsistent documentation, variation in care plans, or lack of patient engagement.

Actionable Steps:

• Conduct OASIS coding audits and retraining

• Implement standardized clinical pathways (e.g., for wound care, ambulation)

• Provide staff with real-time OASIS scoring tools and decision support

• Track early functional scores and adjust plans of care proactively

2. Claims-Based Measures

These focus on unplanned hospitalizations and ED use—measures that often hit agencies hard.

Actionable Steps:

• Introduce high-risk patient protocols (e.g., CHF, COPD pathways)

• Strengthen care coordination with primary care and specialists

• Use predictive analytics to flag patients at risk of hospitalization

• Monitor SOC (Start of Care) documentation and medication reconciliation

3. HHCAHPS Survey Measures

These survey scores come directly from patients and can have a significant impact on your TPS.

Actionable Steps:

• Train staff on communication, listening, and engagement skills

• Review feedback trends and use patient comments to coach clinicians

• Follow up after discharge to reinforce positive experiences

• Launch recognition programs for high-performing clinicians

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Step 5: Track, Measure, and Adjust

Improvement is an iterative process. Use internal data dashboards to track progress on your SMART goals. Hold monthly or biweekly huddles to:

• Review new IPRs or internal data

• Celebrate wins and spotlight progress

• Identify roadblocks and adjust interventions

• Revisit and recalibrate goals as needed

✅ Tip: Make sure staff at every level understands how their work connects to performance metrics and financial outcomes.

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Step 6: Close the Loop with Documentation & Communication

A critical but often missed step is documenting your QI activities and communicating them back to staff and leadership. This ensures:

• Transparency: Everyone knows what’s being done and why

• Accountability: Teams see how performance connects to process changes

• Sustainability: QI projects become part of the culture, not one-offs

Develop a monthly or quarterly “IPR Digest” that summarizes:

• Targeted measures

• Actions taken

• Results so far

• Next steps

Post results on bulletin boards, in newsletters, or during all-staff meetings.

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Step 7: Prepare for the Annual TPS and Payment Impact

Finally, remember the IPR is interim—the official scores used for payment adjustments are based on the Annual Performance Report (APR). However, your IPR data gives you a 3- to 6-month head start.

Use Q4 IPRs to simulate your likely final TPS and payment adjustment. Run “what-if” scenarios using CMS’s scoring methodology to see how improvements in certain measures will impact your bottom line.

This allows you to focus resources on high-impact initiatives before it’s too late to move the needle.

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Real-World Example: Turning Data into Dollars

Let’s say your agency’s IPR shows:

• Hospitalization rate at the 30th percentile

• Improvement in Ambulation at the 45th percentile

• HHCAHPS “communication” score in the bottom quartile

Your QI team could:

1. Launch a hospital readmission reduction program for high-risk patients

2. Provide physical therapy training for clinicians on ambulation strategies

3. Run customer service workshops to boost communication scores

By Q3, you track improvements through mock HHVBP dashboards and internal data. By Q4, your IPR shows a 5-point bump in TPS—enough to move you from a payment penalty to a bonus.

This is the essence of going from report to action.

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Common Pitfalls to Avoid

• ❌ Ignoring the IPR because “it’s not final”

• ❌ Only focusing on low scores without weighing TPS impact

• ❌ Improving measures without changing underlying processes

• ❌ Not engaging clinicians in quality initiatives

• ❌ Failing to track and communicate progress

Avoid these mistakes by integrating your IPR into a broader performance improvement culture.

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Final Thoughts: Make the IPR Your Strategic Advantage

CMS created the IPR not just as a performance snapshot but as a performance accelerator. Used wisely, it can help your agency:

• Drive data-driven decision-making

• Prioritize the right quality initiatives

• Engage staff in continuous improvement

• Improve patient care and experience

• Maximize your HHVBP bonus potential

It’s not just a report. It’s a roadmap to better outcomes.

So, the next time that IPR hits your inbox, don’t just file it away. Gather your team, dig into the data, and start turning insights into action.

Your patients—and your bottom line—will thank you.

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