Provider alliance Premier Inc. is taking issue with the final rule published on April 29 to establish the Hospital Value-Based Purchasing program tying acute care Medicare payments to quality of care.

The organization is disappointed that the Centers for Medicare and Medicaid Services "essentially ignored comments from the field on the proposed Medicare value-based purchasing rule and did not adjust its policies accordingly," read a statement from Premier. "CMS has inappropriately weighted the Hospital Consumer Assessment of Healthcare Providers and Systems survey. While inclusion of HCAHPS is an important advancement of patient-centered care, a 30 percent weighting is excessive, since research shows that high-acuity or depressed patients score their experience at a lower level. Because of this, we believe that CMS' policy will disadvantage hospitals that take on complex patients."

Premier also contends that performance thresholds are overly ambitious in the first year of the program, and opposes adoption of "buggy" patient safety and inpatient quality measures from the Agency for Healthcare Quality and Research. "These measures do not have substantial evidence to support their ability to identify true differences in hospital performance, and some have very high false positive rates."

--Joseph Goedert


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