What Is an Interim Performance Report (IPR) in HHVBP—and Why It Matters

If you’re involved in home health care, you’ve likely heard of HHVBP—the Home Health Value-Based Purchasing model. And if you’ve spent any time navigating this program, you may have come across a term called the Interim Performance Report (IPR).

At first glance, the IPR might just look like another report in a sea of Medicare paperwork. But in reality, it’s much more than that. It’s one of the most important tools home health agencies can use to understand their performance, make data-driven decisions, and ultimately improve patient care while optimizing their Medicare reimbursement.

Whether you’re new to HHVBP or just looking for a clear explanation, this blog breaks down what the IPR is, how it fits into the HHVBP model, and why it’s so important for your agency’s success.

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A Quick Refresher: What Is HHVBP?

Before diving into the IPR, let’s start with a quick refresher on HHVBP.

The Home Health Value-Based Purchasing (HHVBP) Model is a payment system launched by the Centers for Medicare & Medicaid Services (CMS). Instead of paying home health agencies (HHAs) the same amount regardless of performance, HHVBP adjusts Medicare payments based on how well an agency delivers care.

In simple terms: better care can lead to higher payments; poor performance can result in payment reductions.

The Goal of HHVBP:

• Improve the quality and efficiency of home health care services

• Encourage agencies to focus on patient outcomes

• Reward agencies that provide high-value, patient-centered care

Key Components of HHVBP:

1. Performance Measures – Agencies are scored based on a set of quality measures, such as hospital readmission rates, patient satisfaction, and timely initiation of care.

2. Total Performance Score (TPS) – Each agency receives a TPS based on its performance compared to other agencies.

3. Payment Adjustment – Based on the TPS, CMS applies a positive or negative payment adjustment (up to 5% by 2025).

Now that you have the basic idea of HHVBP, let’s talk about where the Interim Performance Report (IPR) comes into play.

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What Is an Interim Performance Report (IPR)?

The Interim Performance Report, or IPR, is a quarterly report provided by CMS to all participating HHAs in the HHVBP model. This report gives agencies a snapshot of their current performance relative to the program’s benchmarks.

Think of it like a report card—but updated throughout the year.

It helps agencies understand:

• How they’re doing on individual quality measures

• Where they stand compared to other agencies in their state

• How their current performance may impact future Medicare payments

Each IPR includes detailed data that agencies can use to analyze trends, identify areas of weakness, and track improvement over time.

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Why the IPR Exists: Transparency and Accountability

The main purpose of the IPR is to help home health agencies monitor their progress throughout the performance year. CMS doesn’t want agencies to wait until the end of the year to find out how they performed—by then, it’s too late to make changes.

Instead, by issuing quarterly IPRs, CMS gives agencies regular feedback on their performance. This proactive approach allows agencies to:

• Identify underperforming measures early

• Intervene and implement quality improvement strategies

• Track the effectiveness of performance initiatives

• Forecast future payment adjustments

In other words, the IPR isn’t just a scorecard—it’s a management tool.

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What’s Inside an IPR?

So, what does the IPR actually look like?

Here’s a breakdown of the key components:

1. Quality Measures Performance

The IPR provides data on the specific quality measures used in HHVBP, which fall into several categories:

• OASIS-based measures (collected through the Outcome and Assessment Information Set)

• Claims-based measures (like hospitalization rates)

• HHCAHPS measures (Home Health Consumer Assessment of Healthcare Providers and Systems—patient satisfaction surveys)

The report shows your agency’s:

• Current score on each measure

• Past performance for comparison

• How your score stacks up against the national and state averages

2. Linear Scores and Achievement/Improvement Points

HHVBP uses a scoring system that awards points for either:

• Achieving high performance (compared to your peers), or

• Showing improvement from your own baseline performance

The IPR outlines how many points you’ve earned for each measure in each category, which directly contributes to your Total Performance Score (TPS).

3. TPS Breakdown

Your Total Performance Score is a weighted combination of all the individual measure scores. The IPR shows how your TPS is trending and how it compares to other agencies.

4. Payment Adjustment Preview

Based on your current TPS, the IPR includes a projection of your Medicare payment adjustment—whether it looks like you’ll receive a bonus or a penalty. This gives you a sense of where you’re headed financially.

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How Often Are IPRs Released?

CMS releases IPRs quarterly—four times per year.

Each report reflects performance data for a rolling 12-month period. This means you’re always looking at the most recent year of data, even though the report is updated quarterly.

Here’s a rough schedule of release:

This rolling window ensures that agencies see their most up-to-date data and can continuously monitor trends and performance.

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Why the IPR Matters for Home Health Agencies

The IPR isn’t just something to check off your list—it’s a strategic tool that can have a direct impact on your agency’s operations and revenue.

Here’s why it matters:

1. It Helps You Stay Ahead of the Game

By reviewing the IPR quarterly, you can spot issues before they become major problems. For example, if your hospitalization rate starts to creep up, you can investigate why and take corrective action immediately—rather than finding out a year later when your payment is penalized.

2. It Directly Impacts Your Bottom Line

Because HHVBP ties performance to payment, the IPR has real financial implications. Agencies that actively use the report to improve can position themselves for positive payment adjustments. Those that ignore it risk leaving money on the table—or worse, facing financial penalties.

3. It Supports Quality Improvement Efforts

The IPR is full of actionable data. Use it to:

• Set internal performance targets

• Track the impact of training programs or care redesign initiatives

• Identify high- and low-performing teams

• Celebrate wins and share best practices

4. It Encourages Team Engagement

Sharing IPR insights with clinical and administrative staff can boost awareness and engagement. When teams see how their work directly affects agency performance and payment, they’re more likely to buy into quality initiatives.

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Best Practices: How to Use the IPR Effectively

Getting the IPR is one thing—using it well is another. Here are some tips for making the most of your report:

✅ Review It Promptly

Set aside time after each release to thoroughly review the IPR. Don’t let it sit in your inbox.

✅ Involve Leadership and Frontline Staff

Hold a monthly or quarterly meeting to review key metrics and trends from the IPR. Engage both leaders and clinicians in the conversation.

✅ Use It to Guide Strategy

Let the IPR drive your quality improvement planning. If certain measures are consistently underperforming, prioritize them in your next improvement cycle.

✅ Track Progress Over Time

Compare IPRs quarter to quarter. Are you improving? Are interventions working? Use trend data to refine your approach.

✅ Connect the Dots to Reimbursement

Remind staff that this isn’t just about scores—it’s about how much your agency gets paid. The better the performance, the better the bottom line.

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Common Challenges and How to Overcome Them

Like any data-driven report, the IPR can feel overwhelming at first. Here are a few common challenges agencies face—and how to handle them.

❌ Challenge 1: Not Understanding the Scoring

Solution: Invest in basic training for your team on how HHVBP scoring works. CMS and many industry associations offer great resources.

❌ Challenge 2: Not Acting on the Data

Solution: Build a structured workflow for reviewing and responding to IPR data—don’t let it become passive information.

❌ Challenge 3: Staff Resistance

Solution: Frame the IPR as a tool for improvement and recognition, not punishment. Celebrate progress!

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Final Thoughts: The IPR Is Your Agency’s Compass

In the world of HHVBP, success isn’t just about providing great care—it’s about measuring, tracking, and continuously improving that care. The Interim Performance Report is your compass on that journey.

It shows you where you are, how you compare, and where you’re headed. Use it wisely, and it can lead your agency toward better outcomes, higher patient satisfaction, and stronger financial performance.

So the next time your IPR arrives, don’t just glance at it—dig in. It could be the most powerful report you get all quarter.