1,800 hospitals increase payments under value-based purchasing

CMS will reward more hospitals in 2016 than last year
Tools

More than 1,800 hospitals will receive a boost in federal reimbursements next year under the Centers for Medicare & Medicaid Services' value-based purchasing plan.

The agency announced Monday that 600 more hospitals will earn increased payments than the year before. Of the participating hospitals in the program, half will either lose or gain 0.4 percent. The top performers will receive a 3 percent boost in payments while the worst performers will be docked a maximum of 1.75 percent. 

The program will "pay most hospitals more or less for each Medicare fee-for-service discharge in FY 2016 than they would've been paid in the absence of the program," according to CMS. Overall, about $1.5 billion in incentives is available, according to CMS.

The announcement comes a few weeks after a Government Accountability Office (GAO) report found that the value-based purchasing program has not generated significant improvements in care its first three years, FierceHealthcare previously reported. At 75 percent of participating hospitals, the increase or decrease in payments came to less than half a percentage point, with a median bonus payment of $39,000 and a median penalty of $56,000. The results heavily favored hospitals that were already financially successful, according to the GAO.

In yesterday's announcement, CMS said it would make modifications to the value-based purchasing program's measures in fiscal 2017, adding two safety measures used to process the scores: hospital-onset methicillin-resistant Staphylococcus aureus infection and early elective deliveries. The program will also remove six "topped-out" clinical measures from reimbursement calculations.

To learn more:
- read CMS' fact sheet

Related Articles:
Three years into value-based purchasing, hospitals have little to show for it
Shift from fee-for-service to value-based models slower than expected
Feds speed plans for value-based payments
The evolution of ACOs and what it may look like in the future [Special Report]
Medicare Advantage plans to test value-based insurance design model
Competition hard to come by in Medicare Advantage markets