CMS proposes value-based purchasing

The Centers for Medicare and Medicaid Services has published a proposed rule to implement a hospital value-based purchasing program mandated under the Affordable Care Act.


The Centers for Medicare and Medicaid Services has published a proposed rule to implement a hospital value-based purchasing program mandated under the Affordable Care Act.

Under the program, hospitals can receive incentive payments for meeting certain performance standards--not just reporting performance measures. The program will apply to payments for discharges in fiscal 2013 starting Oct. 1, 2012.

"The measures we are proposing to initially adopt for the program are a subset of the measures that we have already adopted for the existing Medicare Hospital Inpatient Quality Reporting Program, formerly known as the Reporting Hospital Quality Data for the Annual Payment Update Program, and we are proposing, based on whether a hospital meets or exceeds the performance standards that we are proposing to establish with respect to the measures, to reward the hospital based on its actual performance, rather than simply its reporting of data for those measures."

The existing inpatient quality and proposed value-based reporting programs "have important areas of overlap and synergy with respect to the reporting of quality measures under the HITECH Act using EHRs," according to the proposed rule. "We believe the financial incentives under the HITECH Act for the adoption and meaningful use of certified HER technology by hospitals will encourage the adoption and use of certified EHRs for the reporting of clinical quality measures under the Hospital IQR program which are subsequently used for the Hospital VBP Program.

"We note that the provisions in this proposed rule do not implicate or implement any HITECH statutory provisions. Those provisions are the subject of separate rulemaking and public comment."

The proposed rule is available here.

--Joseph Goedert

 

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