The CMS plans to make improvements to its Hospital Compare Web site as part of a new pay-for-performance program it introduced yesterday.
Under this new "value-based purchasing" program, a percentage of the hospital's base operating payment for each discharge or DRG payment would be contingent on the hospital's actual performance on a specific set of measures, the CMS explained in a report that details the new program. The report was submitted to Congress yesterday. Hospitals would continue to report quality measures on the Hospital Compare Web site under value-based purchasing, the agency stated.
The CMS specifically said it wanted to make enhancements to the Web site "to support expanded and more user-friendly public reporting." The site is a quality tool that may be accessed by the public and rates hospitals on certain measures of care, such as treatment for heart attack, patient surgery and pneumonia.
The value-based purchasing proposal would build upon the current hospital quality-reporting program that was enacted in 2005.
One possible way to phase in the program would be to reward incentives based entirely on reporting the first year; then in the second year, base rewards on 50% reporting, 50% performance; and in the third year, move entirely to a system of performance incentives, acting CMS Administrator Kerry Weems told reporters during a teleconference yesterday.
The current payment system only pays for the volume of procedures rather than rewarding hospitals for delivering evidence-based quality measures and improved patient outcomes, said Blair Childs, senior vice president of public affairs with Premier healthcare alliance, in a written statement. The new program would move hospitals to a system "that rewards the best performers," Childs said.
The report on value-based purchasing under a mandate of the Deficit Reduction Act of 2005 was supposed to be released months ago. "This is a complex area, and we wanted to make sure what we sent to Congress was right," Weems said.
Such a program would require congressional approval to be implemented. The hope is the Senate will include these new measures as it drafts Medicare legislation next week, Weems said.
"Value-based purchasing could really transform our healthcare system and make the system better for patients. It means that a Medicare beneficiary would know that the quality of care he or she gets is part of the bottom-line calculation the hospital is making," said Sen. Chuck Grassley (R-Iowa), ranking member of the Senate Finance Committee, in a written statement. "Now that the plan is set," he said, "Congress needs to get the job done and pass additional legislation to start implementing value-based purchasing."
A CMS spokesman said the Hospital Compare Web site would continue to receive updates and improvements, regardless of whether Congress approves the new proposal.
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