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To: HHA Providers, CMS Staff
Expanded HHVBP Model: Preliminary CY 2026 Annual Performance Reports (APRs) are Available in iQIES
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Preliminary CY 2026 Annual Performance Reports (APRs) are Available in iQIES
The Preliminary CY 2026 Annual Performance Reports (CY 2026 APRs) for the expanded HHVBP Model have been published in the Internet Quality Improvement and Evaluation System (iQIES).
The CY 2026 APRs provide the HHA’s APP based on performance in CY 2025, the performance year, which will be applied to Medicare Fee-for-Service (FFS) claims with through dates in the payment year, CY 2027. In addition, the CY 2026 APRs provide information related to HHA performance on key metrics that feed into the HHA’s APP, including performance measure scores, Improvement Points, Achievement Points, Care Points, and the Total Performance Score (TPS). An HHA receives a CY 2026 APR if the HHA was Medicare-certified prior to January 1, 2024, had a prior year payment amount, and had sufficient data for at least five (5) quality measures to calculate a Total Performance Score (TPS) and Adjusted Payment Percentage (APP). Exhibit 1 shows the performance periods by measure category.
The CY 2026 APR is the first APR in the expanded HHVBP Model that uses the CY 2025 applicable measure set, which includes three (3) OASIS-based, two (2) claims-based, and five (5) HHCAHPS Survey-based measures:
OASIS-based Measures:
- Improvement in Dyspnea (Dyspnea) – One-year measure
- Improvement in Management of Oral Medications (Oral Medications) – One-year measure
- Discharge Function Score (DC Function) – One-year measure
Claims-based Measures:
- Discharge to Community-Post Acute Care (DTC-PAC) – Two-year measure
- Home Health Within-Stay Potentially Preventable Hospitalizations (PPH) – One-year measure
HHCAHPS Survey-based Measures:
- Care of Patients (Professional Care) – One-year measure
- Communications between Providers and Patients (Communication) – One-year measure
- Specific Care Issues (Team Discussion) – One-year measure
- Overall Rating of Home Health Care (Overall Rating) – One-year measure
- Willingness to Recommend the Agency (Willingness to Recommend) – One-year measure
Exhibit 1: CY 2026 APR quality measure performance scores time periods for each measure category
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Measure Category
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Time Period
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Minimum Data Threshold
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OASIS-based
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January 1 – December 31, 2025
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20 home health quality episodes
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Claims-based
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PPH: January 1 – December 31, 2025
DTC-PAC: January 1, 2024 – December 31, 2025
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20 home health stays
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HHCAHPS Survey-based*
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January 1 – December 31, 2025
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40 completed surveys
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*Not included in the TPS calculation for HHAs in the smaller-volume cohort.
Note: APRs are only available to HHAs through iQIES.
For additional details on cohort assignment in the expanded Model, please review Section 2 in the Expanded HHVBP Model Guide, available on the Expanded HHVBP Model webpage, under “FAQs & Model Guide."
Note: APRs are only available to HHAs through iQIES.
Below is a list of the calendar years that are relevant to the “CY 2026 APR”, namely the baseline year, performance year, publication year, and payment year.
- The baseline year is CY 2023 and is used to calculate quality measure-specific achievement thresholds and benchmarks for all measures except the DTC-PAC measure. For the DTC-PAC measure, CY 2022 and CY 2023 are used. CY 2023 (or CY 2022 and CY 2023 for DTC-PAC) and CY 2024 (or CY 2023 and CY 2024 for DTC-PAC) are used to calculate improvement thresholds depending on an HHA’s initial Medicare certification date and availability of sufficient data in the baseline years.
- CY 2025 is the performance year, and HHA performance in this calendar year is measured against 10 quality measures relative to performance of HHAs in each cohort.
- The publication year of the “CY 2026 APR” is CY 2026.
- CY 2027 is the payment year. That means that the HHA’s APP ranging from minus 5% to plus 5% is applied to Medicare Fee-for-Service (FFS) claims with through dates in CY 2027. Note that CMS applies the payment adjustment percentage to Home Health Prospective Payment System (HH PPS) Medicare claims, which are only available for Medicare (FFS) beneficiaries. Please note that this does not preclude other non-Medicare FFS payers (e.g., Medicare Advantage, Medicaid and managed Medicaid) from utilizing an agency’s HHVBP annual payment adjustment. For more information on the billing process, please review the “Billing Process” section in the Expanded HHVBP Model Guide.
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Accessing APRs
APRs are available via iQIES in the “HHA Provider Preview Reports” folder, by the CMS Certification number (CCN) assigned to the HHA. If your organization has more than one (1) CCN, then a report will be available for each CCN. Only iQIES users authorized to view an HHA’s reports can access expanded HHVBP Model reports. For assistance with downloading your HHA’s APR, please contact the iQIES Service Center at 1-800-339-9313, Monday through Friday, 8:00 AM-8:00 PM ET, or by email (iqies@cms.hhs.gov). To create a ticket online or track an existing ticket, please go to CCSQ Support Central.
- Log into iQIES at https://iqies.cms.gov/.
- Select the My Reports option from the Reports menu.
- From the My Reports page, select the HHA Provider Preview Reports folder. The folders and reports on the My Reports page are listed in alphabetical order. Thus, users may need to utilize the “page forward” functionality at the bottom of the webpage to advance to the page where the HHA Provider Preview Reports folder is located. Alternatively, users may change the default number of rows that display on the webpage from 10 to a larger number to view the larger list of folders. Note: Files in the HHA Provider Preview Reports folder are listed in descending order (i.e., in the order of the newest reports to the oldest).
- Select the HHVBP report file, and the contents of the file will display.
Please refer to the Accessing Reports in iQIES resource for instructions on how to access these reports in iQIES. Since access to HHVBP performance reports is limited to authorized iQIES users, HHAs should keep iQIES access up to date, particularly following staffing changes.
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The Appeals Process
There are three (3) versions of the APRs: a Preview APR, a Preliminary APR, and a Final APR.
- The “Preview APRs” were published on August 20, 2026. HHAs had 15 calendar days to submit a recalculation request if they found evidence of an error in their report. The deadline for submitting a recalculation request for the CY 2026 APRs was September 4, 2026.
- The “Preliminary APRs” were published on October 1, 2026 and reflect any changes resulting from an approved recalculation request.
- HHAs will have 15 calendar days from the publication of the “Preliminary APRs” to submit a reconsideration request if they submitted a recalculation request and are not in agreement with the recalculation request decision. Note: HHAs that did not submit a recalculation request are not eligible to submit a reconsideration request. The deadline for submitting a reconsideration request for the CY 2026 APRs is October 16, 2026.
- HHAs will also have 7 calendar days from the notification of the reconsideration request decision to submit a request for Administrator review if they submitted a reconsideration request and are not in agreement with the reconsideration request decision. Note: HHAs that did not submit a reconsideration request are not eligible to submit a request for Administrator review. The deadline for submitting a request for Administrator review for the CY 2026 APRs is November 5, 2026.
- CMS makes the “Final APRs” available after all recalculation requests, reconsideration requests, and requests for Administrator review are processed, and no later than 30 calendar days before the payment adjustment takes effect on January 1, 2027.
HHAs that submitted a recalculation request by September 4, 2026 received instructions on how to submit a reconsideration request as part of the email notifying them of the outcome of the recalculation request decision.
Contact Us
Please do not reply to this email – this is an unmonitored inbox. If you require assistance, use the following options:
- For program questions about the expanded HHVBP Model, contact the HHVBP Model Help Desk at HHVBPquestions@cms.hhs.gov.
- For support with registration for the Internet Quality Improvement and Evaluation System (iQIES), please contact our QIES/iQIES Service Center by phone at (800) 339-9313 or by email at iqies@cms.hhs.gov. You may also refer to the iQIES Onboarding Guide posted to QTSO for registration support: https://qtso.cms.gov/software/iqies/reference-manuals.
- To receive email updates about the expanded Model, please subscribe to the Expanded HHVBP Model listserv. Enter your email address in the contact form, then select “Home Health Value-Based Purchasing (HHVBP) Expanded Model” from the Innovations list.
- Please contact the Home Health Quality Reporting Program (HH QRP) Help Desk at homehealthqualityquestions@cms.hhs.gov for questions about the following: Home Health Quality, including Care Compare (excluding HHCAHPS), OASIS coding and OASIS documentation, quality reporting requirements & deadlines, data reported in quality reports, measure calculations, Quality of Patient Care Star Rating (excluding suppression requests), public reporting, risk adjustment, and Quality Assessment Only (QAO)/Pay for Reporting (P4P).
- Please contact the Home Health CAHPS Help Desk at hhcahps@rti.org for questions related to the HHCAHPS Survey or Patient Survey Star Ratings.
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Important Links:
Expanded HHVBP Model webpage | Expanded HHVBP Model YouTube playlist
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