42 CFR § 484.358 - HHVBP Measure removal factors.

---
identifier: "/us/cfr/t42/s484.358"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 484.358 - HHVBP Measure removal factors."
title_number: 42
title_name: "Public Health"
section_number: "484.358"
section_name: "HHVBP Measure removal factors."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "G"
subchapter_name: "STANDARDS AND CERTIFICATION"
part_number: "484"
part_name: "HOME HEALTH SERVICES"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302 and 1395hh."
regulatory_source: "54 FR 33367, Aug. 14, 1989, unless otherwise noted."
cfr_part: "484"
---


# 484.358 HHVBP Measure removal factors.

CMS may remove a quality measure from the expanded HHVBP Model based on one or more of the following factors:

(a) Measure performance among HHAs is so high and unvarying that meaningful distinctions in improvements in performance can no longer be made (that is, topped out).

(b) Performance or improvement on a measure does not result in better patient outcomes.

(c) A measure does not align with current clinical guidelines or practice.

(d) A more broadly applicable measure (across settings, populations, or conditions) for the particular topic is available.

(e) A measure that is more proximal in time to desired patient outcomes for the particular topic is available.

(f) A measure that is more strongly associated with desired patient outcomes for the particular topic is available.

(g) Collection or public reporting of a measure leads to negative unintended consequences other than patient harm.

(h) The costs associated with a measure outweigh the benefit of its continued use in the program.

(i) It is not feasible to implement the measure specifications.

[88 FR 77878, Nov. 13, 2023, as amended at 90 FR 55619, Dec. 2, 2025]