VBP tweaks draw crit­i­cism

Value-based pur­chas­ing changes get poor re­views

Modern Healthcare - - Front Page - Paul Barr

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

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