Berwick Announces CMS Final Value-Based Purchasing Rules

Cheryl Clark, April 29, 2011

Hospitals now have the final set of Value Based Purchasing rules  governing how they will be paid based on quality performance, which will weight clinical measures at 70% and patient experience measures at 30%.

In a news briefing on the rules Friday, Centers for Medicare & Medicaid Services administrator Donald Berwick, MD, called the new rules "a historic change. For the first time, hospitals around the country are going be paid for inpatient acute services based on healthcare quality, not on just on the quantity of services they provide. "

Beginning in fiscal year 2013 hospitals will continue to receive payment from Medicare, but will receive an across-the-board cut in reimbursement of 1%. That amount, estimated at about $850 million, will be used to reward improvement and achievement under the program.

"Changing the way we pay hospitals will improve the quality of care for seniors and save money for all of us," U.S. Health and Human Services Secretary Kathleen Sebelius said in a statement released to the media. "Under this initiative, Medicare will rewards hospitals that provide high-quality care and keep their patients healthy.  It's an important part of our work to improve the health of our nation and drive down costs.

"As hospitals work to improve their performance on these measures, all patients – not just Medicare patients – will benefit."

In the briefing, Berwick added:

"In 2009, more than 700 million Medicare beneficiaries were in the hospital. And [there were] more than 12.4 million hospitalizations. Quality for these people varies. Many suffer adverse events, such as those we're going to be tackling with Partnership for Patients, and others lack benefit from care due to unreliability in quality of care.


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