What Will Value Based Purchasing Mean for Your Hospital? New White Paper
For years, hospitals throughout the U.S. have diligently submitted their quarterly clinical measures and HCAHPS survey results to the Centers for Medicare and Medicaid Services (CMS) to comply with the “Pay for Reporting” program, in which hospitals receive their full CMS reimbursement for allowing CMS to publicly report results on the Hospital Compare website. The stakes rise considerably on October 1, 2012; however, as the industry moves from “Pay for Reporting” to “Pay for Performance” under the CMS Value Based Purchasing Program. As of October 1st, a hospital’s reimbursement will actually be based on how it performs on 20 quality indicators.
In HealthStream's new white paper, Who Are the Winners in Value Based Purchasing?, our Vice President of Client Services, Robin Rose, examines the Value Based Purchasing program and how hospitals need to be thinking about how this important government program will affect them.
Value Based Purchasing Involves HCAHPS Scores and Quality Measures
More than 3,200 U.S. hospitals are poised to participate in the Value Based Purchasing Program. As part of this program, each hospital is scored on 12 clinical measures and eight HCAHPS survey themes. CMS looks at both current performance as well as improvement over the past two years and assigns an aggregate score to each facility that weights the clinical measures as 70% and the HCAHPS survey results as 30% of the total.
Under Value Based Purchasing, There Will Be Winners and Losers
During the first year of the VBP program, CMS will “hold back” 1% of its total hospital reimbursement for that year (equivalent to roughly $850 million). The 1% hold back from CMS is increased by 0.25% in each subsequent year, until it reaches a full 2% by FY2017. Hospitals with an aggregate VBP score that exceeds the national average receive more than their usual 1% reimbursement from CMS, while hospitals scoring below national norms receive less than 1%. Hospitals can qualify to “earn back” reimbursement ranging from 0% to 2% depending on their performance.
HealthStream Completes an Early Value Based Purchasing Analysis
To calculate each hospital’s VBP scores for FY2013, CMS will compare data from July 1, 2011 – March 31, 2012 to data from July 1, 2009 – March 31, 2010. Since the results from these analyses will not be ready until later in 2012, HealthStream performed similar analyses for this article using data that are currently available in order to project CMS results when they release their VBP scores later this year. In this article, we look first at HCAHPS results by themselves and then examine findings when HCAHPS and clinical scores are viewed simultaneously for each hospital.
Who Are the Winners in Value Based Purchasing? also addresses:
- How hospitals are improving nationally, and what that means for individual organizations
- How small hospitals are top performers
- Who will benefit from Value Based Purchasing
- The role of clinical scores in value based purchasing
- Multiple major implications of value based purchasing for hospitals
Download the free White Paper.