The shift to value-based care is transforming the home- and community-based services (HCBS) industry at its core. This approach moves away from traditional fee-for-service models and instead links reimbursement to the quality and cost-effectiveness of care. For HCBS providers, this change presents both challenges and opportunities — challenges in adapting to new requirements but also opportunities to improve member health outcomes, gain greater financial stability, and establish a competitive edge in the market.
To successfully navigate this new landscape, HCBS providers must prioritize one critical element — performance tracking. Measuring and analyzing health outcomes against payers’ value-based contracting models is essential to optimize reimbursement rates and achieve sustainable growth. In addition, research demonstrates that consistent measurement leads to higher standards of care. A study from the National Library of Medicine found that regularly tracking adherence to protocols over a 10-week period resulted in noticeable improvements in care quality, which persisted for up to 18 months, even without extra training, supplies, or tangible incentives.
Tracking Performance Strengthens Care and Client Satisfaction
Unlike traditional systems that emphasize the volume of services administered, value-based contracting rewards providers for achieving better results, strengthening care efficiency, and enhancing client satisfaction.
The shift ensures that providers are compensated based on measurable performance metrics — such as clinical improvements and reduced hospital readmissions — tying reimbursement directly to the quality and effectiveness of the care they deliver. Additionally, tracking performance allows agencies to pinpoint areas for growth, leading to more impactful and personalized treatment.
Beyond elevating care, strong performance also creates a competitive advantage — providers who consistently excel in key metrics position themselves as industry leaders, fortifying relationships with payers and attracting more clients. Simply put, satisfied patients drive referrals. For every 10% increase in satisfaction, a patient’s willingness to recommend a provider rises by 8.5%, according to a study of factors influencing patients’ likelihood to give a recommendation. So, when implemented effectively, performance tracking isn’t just a compliance measure — it’s a powerful strategy for long-term success.
Identify Essential Metrics to Track
To meet the demands of value-based models, HCBS providers should focus on tracking critical metrics that drive quality care and better outcomes, such as:
1. Clinical Outcomes
Clinical outcomes measure the health improvements clients achieve following care. By tracking indicators like reduced falls, pain management, or mobility progress, agencies can demonstrate the effectiveness of their services.
2. Care Coordination
An often-overlooked aspect of quality care, effective coordination reduces redundancies and enhances client experiences by ensuring caregivers, health professionals, and families work together seamlessly.
3. Client Satisfaction
Value-based care is centered on the individual. Tracking client satisfaction surveys offers actionable insights on where an agency can improve and boosts credibility with both clients and payers.
4. Readmission Rates
Low hospital readmission rates are a strong indicator of high-quality care and cost savings. A study by the University of California, Riverside medical residents estimates that about 20% of readmitted patients experience adverse events after their initial discharge, with medication-related issues being the most common. By addressing this issue and others, such as post-discharge follow-ups, caregivers can positively impact this metric while helping their agencies increase reimbursement rates.
Employ Best Practices for Tracking Performance
Effectively tracking performance requires a structured approach, and HCBS providers can set themselves up for success by following a few key best practices. It starts with setting clear targets and benchmarks — establishing specific, measurable goals aligned with payer expectations gives teams a roadmap for improvement. Whether it’s reducing readmission rates by 10% or strengthening client satisfaction scores, well-defined targets create a focus on progress.
Next, leveraging data analytics tools is essential, as data is at the core of performance tracking. Advanced platforms with pre-built, interactive dashboards designed for homecare make it easier for agencies to collect and pinpoint the most important operational data, set compliance targets, and track progress against goals. However, data alone isn’t enough; its real value comes from strategic decision-making.
Agencies should use insights to guide caregiver training, allocate resources efficiently, and refine workflows. For example, if metrics indicate a rise in medication errors among elderly clients, prioritizing caregiver training on proper medication management could be a critical next step. Finally, continuous monitoring and evaluation ensure providers stay ahead of industry trends and adapt to evolving payer requirements. Performance tracking should be treated as an ongoing strategy rather than a one-time effort.
Consider Additional Strategies for Success in Value-Based Care
While tracking performance metrics is paramount, broader initiatives also play a critical role in value-based care success. HCBS providers can strengthen their resilience and competitiveness by integrating key initiatives alongside performance tracking. Investing in care-coordination technology improves team communication, offers real-time updates, and reduces errors, ultimately enhancing client satisfaction and streamlining workflows.
Developing patient engagement strategies, such as portals, educational resources, and follow-up reminders, encourages individuals to take an active role in their care, leading to better outcomes. Half of all chronic patients reportedly either skip medication doses or stop treatment altogether, leading to 125,000 deaths annually in the U.S. and adding $290 billion in avoidable costs. Expanding engagement has been shown to increase medication adherence by 60%, which helps prevent complications, reduce hospital visits, and optimize overall healthcare efficiency
Additionally, leveraging AI and advanced analytics allows providers to predict and prevent issues before they escalate. For example, using AI-driven analytics to predict falls in clients based on their mobility data could inform a specific fall-prevention plan and training exercises to help an agency reduce incidents and earn higher reimbursements under value-based contracts.
The transition to value-based care is not just a shift in payment models – it represents a fundamental transformation in service delivery. HCBS providers that prioritize performance tracking and strategic innovation have an opportunity to enhance client outcomes, organizational operations, and financial stability. By monitoring key metrics, setting clear benchmarks, and leveraging data analytics, providers can strengthen patient-centered care while driving meaningful change. As roles in the HCBS ecosystem evolve, success will depend on those who can foster sustainable growth and elevate the industry’s standards.
Stephen Vaccaro
Stephen Vaccaro serves as President at HHAeXchange, the leading provider of homecare management solutions for providers, managed care organizations, and state Medicaid agencies, where he leads the market strategy and national expansion of HHAeXchange’s State, Payer, Provider, and Self Direction purpose built technology solutions. With more than 30 years of leadership experience in the healthcare technology space, Stephen understands the business needs of all stakeholders in the homecare ecosystem. He has a proven track record of success in executive leadership, sales, implementation, service delivery, strategic planning, project management, product development, and acquisition integration.
