VBP tweaks draw criticism
Value-based purchasing changes get poor reviews
With hospitals just beginning to report data for the first year of Medicare’s value-based purchasing program, important parts of the CMS’ outline for the program’s second year are getting negative reviews from the industry.
The proposed changes to the value-based purchasing program, which include new weightings for the kinds of measures to be used, were released July 1 as part of an 896page proposed rule for hospital outpatient care and ambulatory surgical center reimbursement. The proposed rule also introduced a long-awaited and welcome qualityreporting program for ASCs.
It is the value-based purchasing provisions that are attracting criticism from officials for hospital groups, who say that some of the measures are untested and getting too much emphasis in the program.
In particular, they continue to oppose the use of the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which they say is likely to penalize hospitals that treat sicker patients, who in general tend to give lower satisfaction scores. As it did for fiscal 2013, the CMS is basing 30% of a hospital’s score in calculating any bonus or penalty it receives on the HCAHPS results.
“We’re very disappointed that CMS kept the HCAHPS at the current level given the deficiencies that we believe are there,” said Karen Fisher, senior director of healthcare affairs for the Association of Academic Medical Colleges.
Hospital industry officials opposed the initial weighting of 30% when it was assigned for fiscal 2013, and continue do so on the same grounds: that HCAHPS needs improvement and should be risk-adjusted for use in the VBP