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CMS recently determined that due to an unintended processing issue, risk adjustment coefficient values for home health (HH) episodes with start of care (SOC) or resumption of care (ROC) completion dates (M0090) on or after January 1, 2025 that were released to the public in 2025 had not been implemented in iQIES HH measure calculation (see HHQRP QM Risk Adjustment Technical Specifications 2026 (PDF), “Downloads” section at Home Health Quality Measures | CMS). Instead, OASIS-based measures for these HH episodes were calculated using the risk adjustment models developed for home health episodes with SOC/ROC completion dates between January 1, 2024 and December 31, 2024 only. The impacted HH episodes with SOC/ROC completion dates between January 1, 2025 and December 31, 2025, were used to calculate a portion of performance measures reported in the following performance reports:
- October 2025 Provider Preview Reports for January 2026 Public Reporting (Q1 2025)
- January 2026 Provider Preview Reports for April 2026 Public Reporting (Q1- Q2 2025)
- April 2026 Provider Preview Reports for July 2026 Public Reporting (Q1- Q3 of 2025)
A correction for this processing issue was deployed in iQIES in early April 2026 and will be reflected starting with the April 2026 IPRs. Note that this necessary correction is limited to HH episodes with SOC/ROC completion dates in CY 2025. Both the HHQRP 2025 QM Manual and risk adjustment technical specifications presented the correct risk adjustment values that were intended for use with HH episodes SOC/ROC completion dates in calendar year 2025.
In sum, the HHQRP 2025 QM Manual and risk adjustment technical specifications presented the correct risk adjustment values that were intended for use with HH episodes SOC/ROC completion dates in calendar year 2025, whereas implementation in iQIES needed to be corrected to align with the documentation.
To assess the implications of this processing issue on publicly reported performance, CMS completed an impact analysis by comparing OASIS-based measure values that were incorrectly risk-adjusted with 2024 risk adjustment coefficients as reported in Risk Adjustment Technical_Specifications_2025 (PDF) with OASIS-based measure values that were correctly risk-adjusted using 2025 risk adjustment coefficients as reported in the HHQRP QM Risk Adjustment Technical Specifications 2026 (PDF). This analysis used a CY 2025 reporting period based on HH episodes ending in CY 2025. Overall, analysis results showed small changes in agency-level OASIS-based measure scores. There were also very small changes to agency-level, relative measure performance rankings for agencies with at least 20 eligible HH episodes to generate a measure value.
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