§ 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]