CMS to expand 'value-based' purchasing efforts

Brace yourself: It looks like CMS is going to expand its value-based purchasing efforts, throwing yet another wrinkle into a relationship that's complicated enough as it is. According to Thomas Valuck, a physician who serves as medical officer and senior adviser in the CMS Center for Medicare Management, CMS believes that value-based purchasing can avoid unnecessary costs and keep the focus on quality of care. The agency has to do something to change how it pays for care, as the Medicare Part A trust fund could be depleted by 2019 if something isn't done, said Valuck, who spoke at a D.C.-based infection control conference last week.

CMS already has several value-based purchasing efforts in place, including the Premier Hospital Quality Incentive Demonstration, nursing home demonstration and the Physician Quality Reporting Initiative, which has apparently been demonstrating some success in cutting costs and improving quality. Value-based thinking also gave CMS officials the motivation for its "no pay for errors" policy, Valuck said.

Valuck didn't specify what other programs CMS has in mind, but we can be pretty sure that in the next year or two, the agency will expand substantially beyond the 11 "never events" for which it won't reimburse. As for pay-for-performance initiatives, providers haven't been thrilled with the size of their bonuses, but CMS is likely to tweak that formula, and may come up with something it can expand there, as well.

To learn more about CMS's plans:
- read this Modern Healthcare piece (reg. req.)

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