1,714 hospitals see payment bump under value-based purchasing: 10 things to know

The Medicare Hospital Value-Based Purchasing Program, established under the Patient Protection and Affordable Care Act, is intended to encourage hospitals to provide high-quality care more efficiently by adjusting payments to hospitals based on the quality of care they provide. In 2015, 1,714 hospitals will receive some bonus payment and 1,375 will receive a payment reduction under the program, according to recently released data on more than 3,000 U.S. hospitals.

Here are 10 things to know about the VBP program and the hospitals receiving bonuses and penalties in fiscal 2015.

1. The VBP program adjusts Medicare payments to hospitals under CMS' Inpatient Prospective Payment System.

2. The 2015 IPPS rule updates the VBP program. In 2014, hospitals could lose up to 1.25 percent of total Medicare payments for performing poorly across the domains scored for the VBP program, and for 2015 the final rule increases the maximum percent reduction to 1.5 percent.

3. There are four VBP program metrics used to score hospitals in fiscal 2015: clinical process of care, patient experience of care, outcomes and efficiency.

4. The metrics are weighted differently, and hospitals' total weighted score is based 30 percent on patient experience of care, 30 percent on outcomes, 20 percent on efficiency and 20 percent on clinical process of care.

5. The largest bonus any hospital will receive under the VBP program for fiscal 2015 is 2.03 percent of total Medicare payments, according to a Leavitt Partners research brief.

6. Hospitals qualified for 5.4 percent the maximum bonus, on average.

7. In fiscal 2014, 46 percent of hospitals received a bonus payment under the VBP, and that number increased to 55.5 percent of hospitals in 2015, according to Leavitt Partners.

8. The largest penalty any hospital will receive under the VBP program for fiscal 2015 is 1.24 percent of total Medicare payments, according to Leavitt Partners.

9. Some hospitals experienced significant positive changes from 2014 to 2015, with 10 percent of hospitals in the lowest quartile for VBP program scores last year scoring in the highest quartile in fiscal 2015, according to Leavitt Partners.

10. There were hospitals that experienced negative changes as well, with 7.3 percent of hospitals in the highest quartile in fiscal 2014 falling to the lowest quartile in 2015, according to Leavitt Partners. 

 

 

 

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