Your HHVBP Annual Performance Report: What the October 1 Report Means for Your 2027 Medicare Payments

On October 1, 2026, CMS is scheduled to post every eligible agency's preliminary Annual Performance Report for the expanded Home Health Value-Based Purchasing model (HHVBP). That report holds one number most owners care about: the percentage CMS will add to, or take off, every Medicare fee-for-service home health claim you bill in 2027.

The range is 5 percent in either direction. The care it is based on already happened, in calendar year 2025. So this is not a report you can do much about. It is a report you need to read, check and budget around.

Here is what is in it, how the number is built, and the one thing most agencies will not realize: for nearly everyone, the window to dispute it has already closed.

Sources: CMS Expanded HHVBP Model Guide (December 2025), the Expanded HHVBP Model June 2026 Newsletter, the CY 2026 Measures and Reports At-A-Glance, and 42 CFR 484.345 through 484.375. Quotes and file hashes are recorded in our source notes. Dates are CMS's published schedule, which CMS says "may be updated as needed."

The Three Reports and the Dates

CMS issues the Annual Performance Report (APR) in three versions. For this cycle, the June 2026 HHVBP newsletter lists these dates, each "or as soon as technically feasible":

The Preliminary APR "reflects the results of any changes due to recalculation requests," according to the model guide. For an agency that did not ask for a recalculation, preview and preliminary will usually match.

Which Year of Care This Covers

HHVBP runs on a two-year lag. The report you get in October covers calendar year 2025 and sets your calendar year 2027 payments. CMS's CY 2026 At-A-Glance puts it plainly: "For the CY 2025 performance year/CY 2027 payment year, eligible Medicare-certified HHAs will receive a Preview APR in August 2026."

That matters for two reasons. First, nothing your team does this fall changes this number. Second, the measure set behind it is not the one you are being scored on right now. CY 2025 was the first year of a new, smaller measure set, and CY 2026 changed it again. Our HHVBP 2026 guide covers the set your 2028 payments ride on.

The Measures Behind the 2027 Number

For the CY 2025 performance year, CMS scored 10 measures: three from OASIS, two from claims and five from the HHCAHPS patient survey. The categories are weighted 35 percent, 35 percent and 30 percent. Within each category, CMS's model guide (Exhibit D-2) assigns these weights:

Two measures carry almost half the score: preventable hospitalizations (26 percent) and Discharge Function (20 percent). If your number surprises you, start there.

The "no HHCAHPS" column applies to the smaller-volume cohort. Under 42 CFR 484.345, that cohort is the agencies exempt from the HHCAHPS survey under §484.245. For them, OASIS and claims measures split the score 50/50 and the patient survey counts for nothing.

Discharge to Community is a two-year measure. Every other measure here is one year.

How Your Score Becomes a Percentage

Your Total Performance Score (TPS) runs from 0 to 100 (42 CFR 484.345). CMS then turns it into a payment percentage with what it calls a linear exchange function. In plain terms, the steps in the model guide (Exhibit 19) are:

1. Take your total Medicare FFS home health payments for 2024, the year before the performance year.
2. Multiply by 5 percent, then by your TPS divided by 100.
3. Scale everyone in your cohort by the same ratio, so the money moved up equals the money moved down. CMS says this is done "to ensure budget neutrality."
4. Convert back to a percentage, subtract 5 percent, and cap the result at plus or minus 5 percent.

The practical consequence is in the model guide's own words: "HHAs that have a TPS that is average in relationship to other HHAs in their cohort would not receive any payment adjustment." Your percentage depends on your score and on everyone else's. A score that improved can still land below zero if your cohort improved more.

Under 42 CFR 484.370(b), the adjustment is applied to each 2027 final claim payment. As a simple illustration: an agency with $2 million in 2027 Medicare FFS home health payments and a minus 1 percent adjustment loses about $20,000 over the year. At plus 1 percent, it gains about the same.

Who Gets a Report

The June 2026 newsletter sets the eligibility for this cycle:

• Medicare certification date before January 1, 2024
• Enough data for at least five measures, so CMS can calculate a TPS
• A prior payment year amount, meaning Medicare FFS home health claims in the year before the performance year

An agency certified in 2024 or later, or one without enough data for five measures, does not get an APR this cycle.

How to Find Your Report

The model guide is specific, and it catches people out:

• APRs are only in iQIES, in the "HHA Provider Preview Reports" folder.
• CMS does not email the reports, and iQIES does not tell you they are there when you log in.
• iQIES users authorized to view your agency's OASIS Quality Report get a GovDelivery email when reports are posted. If nobody at your agency has that access, nobody gets the email.
• Final reports stay in iQIES for 730 days, then are archived.

If you cannot get into iQIES, contact the iQIES Service Center at iQIES@cms.hhs.gov. Model questions go to HHVBPquestions@cms.hhs.gov.

A 30-Minute Check When It Arrives

Even with the appeal window closed, the report is worth half an hour:

1. Confirm the basics. Name, address and CCN. The model guide asks agencies to confirm all identifying information is accurate.
2. Confirm your cohort. Larger-volume or smaller-volume changes which measures count and how much.
3. Compare measure values to your own data. If your vendor's numbers differ, check whether both are risk-adjusted and built from the same source. The guide flags exactly those two questions.
4. Look for missing categories. If a whole category is missing, CMS reweights the rest. That can move the score a lot.
5. Find the payment line. The Annual Payment Adjustment tab shows your prior-year payment, your TPS and your final adjusted payment percentage.
6. If you filed a recalculation, read CMS's decision and decide within 15 calendar days whether to request reconsideration. The regulation, 42 CFR 484.375(b)(2), counts those 15 days from CMS's notice of the recalculation outcome. The guide counts from the preliminary report. Use whichever comes first.

What You Can Still Do

For 2027, not much beyond budgeting. For the years after, a lot:

• Your 2026 care sets your 2028 payments. The measure set changed again for 2026: six OASIS measures, three claims measures and only two HHCAHPS measures, weighted 40/40/20. The details are in our HHVBP 2026 guide.
• Read the quarterly Interim Performance Reports. They come out in January, April, July and October. Each one also opens a 15-day recalculation window. That is where errors get fixed, before they reach an annual report.
• Watch preventable hospitalizations and Discharge Function. They were the two heaviest measures in 2025, and both are still in the 2026 set.

Your Number Will Be Public

This is not a private report card. CMS publishes each qualifying agency's measure results, TPS and payment adjustment percentage on the Provider Data Catalog. Public reporting started in January 2025 and follows the same approximate timeline each year. Referral sources, competitors and anyone else can look it up.

It is separate from the Care Compare star ratings. CMS says the HHVBP data "is supplemental to" the star ratings "and does not form a part of these or other star ratings."

Key Takeaways

• The preliminary HHVBP report is scheduled for October 1, 2026 in iQIES. The final is scheduled for November 25.
• It covers 2025 care and sets your 2027 Medicare FFS payments, up to 5 percent either way.
• An average score in your cohort means no adjustment. Your number depends on everyone else's.
• The recalculation window was 15 days after the August preview was posted (scheduled August 20). Only agencies that filed one can ask for reconsideration now.
• Make sure someone at your agency has iQIES access to the OASIS Quality Report, or you will not get the email.

Frequently Asked Questions

When does CMS release the preliminary HHVBP Annual Performance Report in 2026?

CMS scheduled the preliminary CY 2026 Annual Performance Report for October 1, 2026, "or as soon as technically feasible." The preview report was scheduled for August 20, 2026, and CMS now lists it as available in iQIES. The final report is scheduled for November 25, 2026. All three are posted in iQIES, not emailed.

Which year of care does the October 2026 report cover?

Calendar year 2025. The CY 2025 performance year sets the CY 2027 payment year, so the adjustment in this report applies to your Medicare fee-for-service home health claims in 2027.

How big can the HHVBP payment adjustment be?

Up to 5 percent up or down. 42 CFR 484.345 defines the applicable percent as a maximum upward or downward adjustment not to exceed 5 percent, and CMS caps each agency's final adjusted payment percentage at plus or minus 5 percent.

Can I still appeal my HHVBP payment adjustment after the preliminary report?

Only if you filed a recalculation request on the preview report. The recalculation window was 15 calendar days after the August preview report. CMS's model guide says only agencies that submitted a recalculation request may file a reconsideration request, within 15 calendar days after the preliminary report.

Where do I find my HHVBP Annual Performance Report?

In iQIES, in the HHA Provider Preview Reports folder. CMS does not email the reports and does not flag them when you log in. iQIES users authorized to view your OASIS Quality Report get a GovDelivery email when reports are posted.

Does an average score mean no adjustment?

Yes. CMS's model guide says agencies with a Total Performance Score that is average in relation to the other agencies in their cohort would not receive any payment adjustment. The adjustment depends on your score and on how everyone else in your cohort scored.

Will the public see my HHVBP payment adjustment?

Yes. CMS publishes each qualifying agency's Total Performance Score, measure results and payment adjustment percentage on the Provider Data Catalog. Public reporting started in January 2025 and follows the same approximate timeline each year.

Sources

• Expanded HHVBP Model Guide, December 2025 (CMS)
• Expanded HHVBP Model: June 2026 Newsletter (CMS)
• CY 2026 Measures and Reports At-A-Glance (CMS)
• 42 CFR 484.345, Definitions
• 42 CFR 484.370, Determining and applying the payment adjustment
• 42 CFR 484.375, Appeals process
• Expanded HHVBP Model (CMS Innovation Center)