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]