Value-based purchasing rule for hospitals published

Medicare and Medicaid

Value-based purchasing rule for hospitals published CMS has issued a Final rule implementing an inpatient hospital Value-Based Purchasing (VBP) program starting October 1, 2012, under which value-based incentive payments will be made to hospitals that meet specific performance standards in a given year. The VBP program was authorized under Soc. Sec. Act §1886(o), as added by section 3001(a)of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010. The Proposed rule was published at 76 FR 2454, January 13, 2011 (see ¶220,819).

In FY 2013, an estimated $850 million will be allocated to hospitals based on their overall performance on a set of quality measures that have been shown to improve clinical processes of care and patient satisfaction. The Final rule includes a list of 13 measures (down from 17 listed in the Proposed rule) where hospitals will have to demonstrate that they have followed best clinical practices and enhanced patients’ experiences of care to qualify to receive incentive payments.

The measures include—

How quickly do heart attack patients receive potentially life-saving surgery on their arteries?

How often do surgery patients receive the right treatment at the right time to prevent blood clots?

How often do patients with heart failure get the discharge instructions they need to care for themselves?

How satisfied are patients with their experience of care at the hospital?

The complete list of quality measures is viewable at

The Final rule will be sent as a pamphlet in an upcoming report; the text can be found online at ¶189,008
CCH Chicago Bureau, May 4, 2011

For more information on this and related topics, consult the CCH® Medicare and Medicaid Guide.

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