§484.358. HHVBP Measure removal factors.
42 C.F.R. § 484.358
CMS may remove a quality measure from the expanded HHVBP Model based on one or more of the following factors:
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).
Performance or improvement on a measure does not result in better patient outcomes.
A measure does not align with current clinical guidelines or practice.
A more broadly applicable measure (across settings, populations, or conditions) for the particular topic is available.
A measure that is more proximal in time to desired patient outcomes for the particular topic is available.
A measure that is more strongly associated with desired patient outcomes for the particular topic is available.
Collection or public reporting of a measure leads to negative unintended consequences other than patient harm.
The costs associated with a measure outweigh the benefit of its continued use in the program.
It is not feasible to implement the measure specifications.
Notes, amendments, and revision history
Amendments
[88 FR 77878, Nov. 13, 2023, as amended at 90 FR 55619, Dec. 2, 2025]
Source
Source: 86 FR 62422, Nov. 9, 2021, unless otherwise noted.
Source
Source: 80 FR 68718, Nov. 5, 2015, unless otherwise noted.
Authority
Authority: 42 U.S.C. 1302 and 1395hh.
Source
Source: 54 FR 33367, Aug. 14, 1989, unless otherwise noted.
Amendments
[88 FR 77878, Nov. 13, 2023, as amended at 90 FR 55619, Dec. 2, 2025]