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Berwick Announces CMS Final Value-Based Purchasing Rules

Cheryl Clark, for HealthLeaders Media, April 29, 2011

For scoring on improvement, hospitals will be assessed based on how much their current performance changes from their own baseline period performance.  Points will then be awarded based on how much distance they cover between that baseline and the benchmark score.  Points will only be awarded for improvement if the hospital's performance improved from their performance during the baseline period.

Berwick singled out provisions in the new rules that will reward hospitals for improvements in how patients experience their care. He said reimbursement will be based on "How satisfied are patients with the experience of the care in the hospital using modern ways for patients to talk back to all of us about the experiences they had using systematic, well developed and scientific surveys."

Blair Childs, spokesman for Premier Healthcare Alliance, applauded the rules but said Premier is "disappointed that CMS essentially ignored comments from the field on the proposed Medicare value-based purchasing (VBP) rule and did not adjust its policies accordingly."

He added, " a 30 percent weighting is excessive, since research shows that high-acuity or depressed patients score their experience at a lower level. Because of this, we believe that CMS' policy will disadvantage hospitals that take on complex patients."
CMS plans to add additional measures in time. Specifically, measures will assess whether hospitals:

  • Ensure that patients who may have had a heart attack receive care within 90 minutes;
  • Provide care within a 24-hour window to surgery patients to prevent blood clots;
  • Communicate discharge instructions to heart failure patients; and
  • Ensure hospital facilities are clean and well maintained.

The American Hospital Association said in a statement that it "supports the general direction of CMS' rule, but we are disappointment that our recommendations to improve the VPB program were ignored."

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