Value-based Purchasing Resources
The 2010 Patient Protection and Affordable Care Act contains numerous provisions to bring most providers of care into value-based purchasing (VBP) under Medicare. Several resources are listed below, including background articles, summaries of CMS updates, key dates and methodology information to help you gain a broader understanding of the program and how it affects your organization.
- May 1, 2012 – Press Ganey has updated its Value-Based Purchasing Calculator to incorporate the redistribution of leftover incentive funds and predict an estimated breakeven point for Federal fiscal year (FFY) 2013. Clients who use the calculator can see how much of the reallocated funds that their facility is expected to receive in payment year 2013. The analysis also estimates the breakeven score for FFY 2013, that is, the Total Performance Score that a hospital will need to likely earn its full incentive payment. Contact your Press Ganey account manager to learn more.
- Partners, March/April, "Solving the Larger Payment Puzzle," by Bernard Porter, corporate director of decision support, Baptist Healthcare System. Read more about how this hospital shares VBP scores and financial impact with staff to build awareness and drive focus.
- March 14, 2012 – Press Ganey has updated its Value-Based Purchasing Calculator to reflect new federal fiscal year (FFY) 2014 methodologies. With this latest release, client hospitals can access an accurate picture of their hospital’s performance based on either FFY 2013 or 2014 criteria, and model different scenarios to prioritize improvement opportunities and optimize payment. Read more.
- Read Improving Health Care blog post, "Value-based Purchasing Solutions are Often Hidden Beneath the Surface," by Christina Dempsey, MBA, senior vice president, clinical and operational consulting, Press Ganey, (3/1/2012).
- On Feb. 28, 2012, the Centers for Medicare and Medicaid Services (CMS) hosted a national provider conference call to help providers analyze CMS hospital-specific dry-run performance, which it made available through each hospital's QualityNet account as of Feb. 29. The reports simulate the federal fiscal year (FFY) 2013 program that takes effect Oct. 1, 2012. Read more.
- Jan. 19, 2012 – The Press Ganey Value-Based Purchasing Calculator has been updated to integrate hospitals’ most recent nine months of complete HCAHPS and core measures performance data from Press Ganey databases, enabling hospitals to have a near real-time estimate of their value-based purchasing (VBP) score. Read more.
- On Nov. 1, 2011, CMS announced the hospital VBP final rule for FFY 2014 with modifications to the proposed efficiency and outcome measures. The domain weighting for calculating scores affecting payment in FFY 2014 will be 45% clinical process of care, 30% HCAHPS and 25% outcomes. The new outcomes domain includes mortality measures for AMI, Heart Failure and Pneumonia (expressed as 30-day survival rates). Read Press Ganey’s summary of the changes.
- On Jan. 7, 2011, CMS proposed regulations to implement the Hospital Inpatient Value-based Purchasing Program (VBP), which bases a portion of Medicare payment on hospitals' performance in a range of quality of care and patient satisfaction measures. This program will impact payments for general, acute-care hospitals beginning with Oct. 1, 2012, discharges. Download Press Ganey's analysis (5/26/11).
- Press Ganey's Value-Based Purchasing Calculator can help you optimize your value-based purchasing reimbursement.
- Read "Integrating for Accountable Care: Under Reform, More Providers Look to New Models for Delivering Better Value to Patients," from the November/December 2010 issue of Press Ganey Partners.
- Read "The Grand Experiment: How Health Reform will Change the Health Care Delivery System Forever," from the May/June 2010 issue of Press Ganey Partners.
- Read our summary of the Key Provisions of the 2010 Health Reform Law.
KEY DATES FFY 2013 Baseline and Performance Period
The methodology for FFY 2013 will affect payments to hospitals for inpatient stays beginning Oct. 1, 2012. The performance period data is used to determine your level of achievement.
FFY 2014 Baseline and Performance Periods
- Process of care baseline period was July 1, 2009 – March 31, 2010; performance period includes July 1, 2011 – March 31, 2012 discharges.
- HCAHPS domains baseline period was July 1, 2009 – March 31, 2010; performance period includes July 1, 2011 – March 31, 2012 discharges.
The final rule for FFY 2014 will affect payments to hospitals for inpatient stays beginning Oct. 1, 2013.
- Outcomes domain baseline period is July 1, 2009 – June 30, 2010; performance period is July 1, 2011 – June 30, 2012.
- Process of care baseline period was April 1, 2010 – Dec. 31, 2010; performance period includes April 1, 2012 – Dec. 31, 2012 discharges.
- HCAHPS domains baseline period was April 1, 2010 – Dec. 31, 2010; performance period includes April 1, 2012 – Dec. 31, 2012 discharges.
WHAT YOU NEED TO KNOW - VBP RULE UPDATES, METHODOLOGY, HCAHPS AND CORE MEASURE TRENDS
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