Value Based Purchasing began implementation in 2012, and began its first year (after establishing the baseline) in fiscal year 2013, which ended October 1st; the standard government fiscal year. This program examines two-dozen specific criteria, regardless of the type of hospital (which, of course, differs – if a hospital doesn’t offer one of these options it is not graded or penalized).
Thus far, the program has only run for one year, and while there is some criticism, it will take several years for the program to fully function in its intended design. This also gives hospitals more time to make changes while the standard cut increases from one percent up to two percent gradually over four years.
Some of the hospitals have alleged that specific-care facilities are better designed to optimize the Medicare/Medicaid improvement metrics, because they have fewer guidelines to follow. Proportionately, a hospital that only provides 12 of the guidelines only need make one significant improvements to another hospital’s two for the same effect.
Of course, not all hospitals are faring poorly. Over 300 hospitals went from losing rewards last year, to gaining this year. Even so, 1,451 hospitals received pay cuts in Medicare rates, while 1,231 received raises, according to NPR.
This is also the first year that death rate has been determined as a factor. Additionally, readmission rates are now a factor and previously were not.
The largest winner in this group is Arkansas Heart Hospital, which exclusively treats cardiovascular patients, while the hospital to lose the most was the Gallup Indian Medical Center, also according to NPR.
As the years go by, however, the program aims to comprehensively pair compensation rates for Medicare with the level of care received. As mentioned in our past blog, next year, the standard amount for hospitals to give up will move to 1.5 percent. The hospitals who made improvements above the 50 percent margin will receive additional compensation, and those below the 50 percent will lose their rewards. Even though some changes of the ACA won’t go into effect until as late as 2017, this implementation has remained relatively untouched by the various changes announced after it’s signing into law.
No matter where your business is with VBP, we can help. At MedPartners Health Information Management, we have the proven talent to help your hospital or clinic’s rating in the information management areas. Our sole focus is HIM, and we have been a leader in the industry for years. In the first few years of ACA’s implementation, we have consistently been up to the challenge. So contact us today to see how we can help you.