Why was VBP created?

Published by Charlie Davidson on

Why was VBP created?

The Hospital VBP Program was established by the Affordable Care Act of 2010 (ACA), which added Section 1886(o) to the Social Security Act. These earlier laws established a way for Medicare to pay hospitals for reporting on quality measures, a necessary step in the process of paying for quality rather than quantity.

What is a VBP model?

Value Based Payment (VBP) is a concept by which purchasers of health care (government, employers, and consumers) and payers (public and private) hold the health care delivery system at large (physicians and other providers, hospitals, etc.) accountable for both quality and cost of care.

When was VBP created?

2010
As a result of The Affordable Care Act of 2010, Centers for Medicare & Medicaid Services (CMS) initiated The Hospital Value-Based Purchasing (VBP) Program, which rewards acute-care hospitals across the country with incentive payments for the quality of care provided to the Medicare population.

What is the hospital VBP program?

The Hospital VBP Program rewards acute care hospitals with incentive payments for the quality of care provided in the inpatient hospital setting. This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

What does VBP stand for?

Linking provider payments to improved performance by health care providers. This form of payment holds health care providers accountable for both the cost and quality of care they provide.

What are capitation payments?

Capitation payments are used by managed care organizations to control health care costs. Capitation is a fixed amount of money per patient per unit of time paid in advance to the physician for the delivery of health care services.

What is the benefit of value based care?

Value-based healthcare focuses on preventative care rather than just treatment of the presenting illness. This leads to a population that is healthier overall, with fewer chronic conditions. A healthier patient population requires fewer services, leading to lower costs.

What four domains are included in the Hospital Value Based Purchasing Program?

A hospital’s performance in the FY 2019 Hospital VBP Program is based on its performance in four quality domains: Clinical Care, Person and Community Engagement, Safety, and Efficiency and Cost Reduction.

How does value based reimbursement work?

Value-Based Reimbursement Models Aim to Improve Care Providers are paid based on the number of patients they have and the number of tests and procedures they order. The more tests ordered, the higher the payment. Value-based care emphasizes high-quality, lower cost, and preventive patient care.

Who benefits from value based reimbursement?

Stronger cost control and reduced risk for payers. The value-based healthcare system benefits patients, healthcare providers, and also payers. Value-based care lowers costs across the board, meaning that insurance companies have to pay out less money for the services their subscribers use.

When does the VBP guidance memo come out?

On August 26, 2020, we issued the COVID-19 IFC, which amended the Extraordinary Circumstance Exception (ECE) announced for the Hospital VBP Program in a press release dated March 22, 2020, and a guidance memo (PDF) issued March 27, 2020.

Is the hospital VBP program based on quality?

The hospital VBP Program rewards acute care hospitals with incentive payments based on the quality of care they provide, rather than just the quantity of services they provide. The statutory requirements of the Hospital VBP Program are set forth in Section 1886 (o) of the Social Security Act.

Where do I find VBP payment adjustment factors?

You can find past Hospital VBP Program value-based incentive payment adjustment factors as posted in Table 16B: The payment adjustment factors are listed by CMS Certification Number (CCN). If you don’t know your hospital’s CCN, you can look it up.

How is the VBP program funded by Medicare?

The Hospital VBP Program is funded by reducing participating hospitals’ FY 2021 base operating Medicare severity diagnosis-related group (MS-DRG) payments by 2%.

Categories: Contributing