CMS issues value-based purchasing rules for hospitals
CMS has issued the final value-based purchasing rules that will tie acute care Medicare reimbursement to hospitals to quality performance starting October 2012, the agency announced Friday.
As previously noted, 1 percent of Medicare payments to hospitals will be withheld during FY 2013, amounting to about $850 million to be awarded to hospitals that meet a set of quality performance measures. Achievement or improvement in patient satisfaction would determine 30 percent of the incentive payments, while improved clinical outcomes would decide 70 percent.
The size of the value-based payments fund will gradually increase over time, as Medicare shifts from payments based on the quantity of services provided to payments based on performance, notes CMS.
Under the new value-based purchasing rules, some of the quality performance measures will evaluate whether hospitals ensure that heart attack patients receive care within 90 minutes; provide care within a 24-hour window to surgery patients to prevent blood clots; give discharge instructions to heart failure patients; and make sure facilities are clean and well maintained.