CMS Proposes Hospital Value-Based Purchasing Rules


On January 7, 2011, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to implement a hospital value-based purchasing (VBP) program as mandated by the Affordable Care Act (ACA). The program would apply to payments for discharges occurring on or after October 1, 2012, and would reward with higher payments hospitals that score well on quality care measures. Comments are due by March 8, 2011. The text of the proposed rule is available here.

The proposed VBP program builds on quality measures already reported by hospitals under the Medicare Hospital Inpatient Quality Reporting Program (Hospital IQR Program), as well as borrowing heavily from a 2007 report that CMS submitted to Congress entitled “Plan to Implement a Medicare Hospital Value-Based Purchasing Program.” Pursuant to the ACA, VBP program incentive payments would be funded by reducing hospitals’ base operating diagnosis related group payments by 1% in fiscal year (FY) 2013, rising to 2% by FY 2017, all of which would be paid out as incentives. The Hospital IQR Program would operate in parallel to the proposed VBP program, and a hospital would be required to continue to participate in the reporting program to avoid payment penalties.

Please see full alert below for more information.

LOADING PDF: If there are any problems, click here to download the file.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Ropes & Gray LLP | Attorney Advertising

Written by:


Ropes & Gray LLP on:

Popular Topics
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.