WASHINGTON – The Department of Health and Human Services has launched an initiative to reward hospitals for the quality of care they provide to Medicare beneficiaries.
The program is the beginning of what HHS officials hope will make pay-for-performance (P4P) the norm. HHS officials said the program would also help reduce healthcare costs.
Authorized by the Affordable Care Act, the hospital value-based purchasing program marks the beginning of a historic change in how Medicare pays healthcare providers and facilities, according to HHS Secretary Kathleen Sebelius. For the first time, she said, 3,500 hospitals across the country will be paid for inpatient acute care services based on care quality, not just the quantity of the services they provide.
"Changing the way we pay hospitals will improve the quality of care for seniors and save money for all of us," Sebelius said. "As hospitals work to improve their performance on these measures, all patients – not just Medicare patients – will benefit."
Under the new value-based purchasing program, in FY 2013 an estimated $850 million will be allocated to hospitals based on their performance on a set of quality measures that have been shown to improve clinical processes of care and patient satisfaction, according to the HHS.
"Medicare is in a unique position to reward hospitals for improving the quality of care they provide," said Centers for Medicare and Medicaid Services Administrator Donald Berwick, MD. "Under this new initiative, we will reward hospitals for delivering high-quality care, treating their patients with respect and compassion, and ensuring they have the opportunity to participate in decisions about their treatment."
According to HHS, some of these 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 better a hospital does on its quality measures, the greater the reward it will receive from Medicare, Sebelius said.
The measures that HHS has selected for the hospital value-based purchasing program in FY 2013 have been endorsed by national bodies of experts, including the National Quality Forum, she added.
The American Hospital Association has said it has "serious concerns" about the inclusion of hospital-acquired conditions in the value-based purchasing program, the weighting of the patient experiences of care survey data, and the required minimum number of patient cases to participate in the program.