# 484.345 Definitions.
As used in this subpart—
*Achievement threshold* means the median (50th percentile) of home health agency performance on a measure during a Model baseline year, calculated separately for the larger- and smaller-volume cohorts.
*Applicable measure* means a measure (OASIS- and claims-based measures) or a measure component (HHCAHPS survey measure) for which a competing HHA has provided a minimum of one of the following:
(1) Twenty home health episodes of care per year for each of the OASIS-based measures.
(2) Twenty home health episodes of care per year for each of the claims-based measures.
(3) Forty completed surveys for each component included in the HHCAHPS survey measure.
*Applicable percent* means a maximum upward or downward adjustment for a given payment year based on the applicable performance year, not to exceed 5 percent.
*Benchmark* refers to the mean of the top decile of Medicare-certified HHA performance on the specified quality measure during the Model baseline year, calculated separately for the larger- and smaller-volume cohorts.
*Competing home health agency or agencies (HHA or HHAs)* means an agency or agencies that meet the following:
(1) Has or have a current Medicare certification; and
(2) Is or are being paid by CMS for home health care services.
*HHA baseline year* means the calendar year used to determine the improvement threshold for each measure for each individual competing HHA.
*Home health prospective payment system (HH PPS)* refers to the basis of payment for HHAs as set forth in §§ 484.200 through 484.245.
*Improvement threshold* means an individual competing HHA's performance level on a measure during the HHA baseline year.
*Larger-volume cohort* means the group of competing HHAs that are participating in the HHCAHPS survey in accordance with § 484.245.
*Linear exchange function* is the means to translate a competing HHA's Total Performance Score into a value-based payment adjustment percentage.
*Model baseline year* means the calendar year used to determine the benchmark and achievement threshold for each measure for all competing HHAs.
*Nationwide* means the 50 States and the U.S. territories, including the District of Columbia.
*Payment adjustment* means the amount by which a competing HHA's final claim payment amount under the HH PPS is changed in accordance with the methodology described in § 484.370.
*Payment year* means the calendar year in which the applicable percent, a maximum upward or downward adjustment, applies.
*Performance year* means the calendar year during which data are collected for the purpose of calculating a competing HHA's performance on measures.
*Pre-Implementation year* means CY 2022.
*Smaller-volume cohort* means the group of competing HHAs that are exempt from participation in the HHCAHPS survey in accordance with § 484.245.
*Total Performance Score (TPS)* means the numeric score ranging from 0 to 100 awarded to each competing HHA based on its performance under the expanded HHVBP Model.
[86 FR 62422, Nov. 9, 2021, as amended at 87 FR 66887, Nov. 4, 2022]