The CMS proposed regulations that would establish in fiscal 2013 a new hospital value-based purchasing program for Medicare that would reward hospitals for providing high quality, safe care for patients.
CMS issues proposed value-based purchasing regs
Required by the Patient Protection and Affordable Care Act, the program applies to payments for discharges occurring on or after Oct. 1, 2012 and would make value-based, incentive payments to acute-care hospitals. Those payments would be based either on how well the hospitals perform on certain quality measures, or how much the hospitals’ performance improves on certain measures from their performance during a baseline period. According to the CMS, the higher the performance, the higher the incentive payment will be.
The financial incentives would be funded through a reduction in the base operating DRG payments for each discharge, which would be 1% in fiscal 2013 and increasing to 2% by fiscal 2017. According to the CMS, the agency proposes to use 17 clinical process-of-care measures as well as eight measures from the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS, survey that document patients’ experience of care. In addition, the agency proposes to adopt three mortality outcome measures, eight hospital-acquired condition measures, and nine measures from HHS’ Agency for Healthcare Research and Quality measures for the 2014 Hospital Value-Based Purchasing program.
“The hospital value-based purchasing program proposal expands upon CMS’ long-standing pay-for-reporting program to reward hospitals not just for reporting data, but for the results of that data,” CMS Administrator Donald Berwick said in a news release. “Value-based purchasing repositions Medicare from an observer of nationwide hospital quality to a formidable force in shaping quality going forward.”
The CMS said it will accept public comments on the proposed rule until March 8, 2011, and will respond in a final rule next year.
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