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CMS eyes changes to hospital payment plan

By Patty Enrado

WASHINGTON – The Centers for Medicare and Medicaid Services has released a report to Congress recommending major changes to its Medicare hospital reimbursement system.

Touting quality of care, CMS proposes reducing payments to all hospitals by 2 percent to 5 percent and using that money to create an incentive pool to reward facilities that meet quality performance metrics.

The pay-for-performance program, or "Value-Based Purchasing Program," would base payment for each hospital discharge on quality performance and reward two groups of hospitals – facilities that demonstrate quality improvement and those that meet quality indicators.

Patient outcomes, clinical practice adherence and patient satisfaction are among the areas that would impact a hospital's total performance score for quality improvement.

 

According to CMS, these changes constitute another way for the agency to "continue transforming Medicare into a prudent purchaser of higher quality health care for Medicare beneficiaries."

"Getting hospitals to report their quality measures was an important first step," said Kerry Weems, acting administrator of the CMS, in a prepared statement. "Now, building on that experience, we are taking the next step of actually rewarding hospitals for the quality of care they provide Medicare beneficiaries."

The proposed changes require Congressional approval.