The Secretary of Health and Human Services on Nov. 26 released its Report to Congress: Plan to Implement a Medicare Hospital Value-Based Purchasing Program, suggesting ways to continue transforming Medicare into a prudent purchaser of higher-quality health care for Medicare beneficiaries. The report includes a plan for the proposed Medicare hospital value-based purchasing (VBP) program.
The plan provides that quality of care information will be available to patients on the Centers for Medicare and Medicaid Services (CMS) Hospital Compare web site. Inclusion of a broad range of quality measures in VBP is intended to enable Medicare beneficiaries and other consumers to compare hospitals and make informed decisions about where to seek care. It builds on the foundation of the current pay-for-reporting program, which ties a portion of the annual payment update under the Medicare inpatient prospective payment system to a hospital’s reporting on a defined set of inpatient quality measures.
Under VBP, a percentage of the hospital’s diagnosis-related group payment would be contingent on the hospital’s actual performance on a specific set of measures. The transition from pay-for-reporting to an incentive based completely on performance would occur over a three-year period. Public reporting of quality measures on Medicare’s Hospital Compare site would remain an essential component of VBP. By tying a portion of hospital payments to actual performance on quality measures, VBP is intended to provide additional incentives for hospitals.
The plan will require Congressional action for implementation, said Kerry Weems, CMS acting administrator, on a press call announcing the release. Download the report.
