Medicare Value Based Purchasing Andrew B. Wheeler Vice President of Federal Finance
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1 Medicare Value Based Purchasing Andrew B. Wheeler Vice President of Federal Finance
2 What is Medicare s VBP System? Incentive program to improve outcomes, safety, patient satisfaction, and efficiency Influences Medicare inpatient prospective payment system operating payments Adjustments to hospital payments began October 1,
3 How is VBP Funded? Budget Neutral participating hospital funded Some hospitals pay while some hospitals bonus Program phases in - 1% adjustment to Medicare operating revenue in 2013, increasing to 2% by
4 Participating Hospitals All Inpatient Prospective Payment System (IPPS) Hospitals are included except: Hospitals and hospital units excluded from the IPPS (psych, rehab, LTCH, children s and cancer hospitals) Hospitals that do not participate in Hospital IQR during the performance period Hospitals cited by the Secretary of HHS for deficiencies during the performance period that pose an immediate jeopardy to patients health or safety Hospitals that do not meet the minimum number of cases, measures, or surveys 4
5 Value-Based Purchasing FFY 2018 Value-Based Purchasing FFY 2019 Clinical Care Efficiency and Cost AMI 30 Day MORT-30-AMI HF 30 Day MORT-30-HF With Nurses With Doctors Patient Indicator PSI-90 Central Line- Associated Blood Stream Infections (CLABSI) HAI-1 Medicare Spending Per Beneficiary SPP-1 Pneumonia 30 Day MORT-30-PN Complication Rate Responsiveness About Medicines Clean and Quiet Discharge Info Catheter-Associated Urinary Tract Infection (CAUTI) HAI-2 Pooled Surgical Site Infection Colon and Abdominal Hysterectomy SSI Overall Rating Care Transitions CTM_3 Clostridium difficile Infection (C diff) CDI Methicillin-Resistant Staphlococcus aureus Bacteremia MRSA Elective Delivery PC-01 *New for FFY 2019 (October 1, 2018 September 30, 2019) 5
6 Value-Based Purchasing FFY 2018 Value-Based Purchasing FFY 2020 Clinical Care Efficiency and Cost AMI 30 Day MORT-30-AMI HF 30 Day MORT-30-HF Pneumonia 30 Day MORT-30-PN Complication Rate With Nurses With Doctors Responsiveness About Medicines Clean and Quiet Central Line- Associated Blood Stream Infections (CLABSI) HAI-1 Catheter-Associated Urinary Tract Infection (CAUTI) HAI-2 Pooled Surgical Site Infection Colon and Abdominal Hysterectomy SSI Medicare Spending Per Beneficiary SPP-1 Discharge Info Overall Rating Care Transitions CTM_3 Clostridium difficile Infection (C diff) CDI Methicillin-Resistant Staphlococcus aureus Bacteremia MRSA Elective Delivery PC-01 *New for FFY 2020 (October 1, 2019 September 30, 2020) 6
7 Value-Based Purchasing FFY 2018 Value-Based Purchasing FFY 2021 Newly Finalized Clinical Outcomes Efficiency and Cost AMI 30 Day MORT-30-AMI HF 30 Day MORT-30-HF Pneumonia 30 Day MORT-30-PN Complication Rate With Nurses With Doctors Responsiveness About Medicines Clean and Quiet Central Line- Associated Blood Stream Infections (CLABSI) HAI-1 Catheter-Associated Urinary Tract Infection (CAUTI) HAI-2 Pooled Surgical Site Infection Colon and Abdominal Hysterectomy SSI Medicare Spending Per Beneficiary SPP-1 COPD 30 Day MORT-30-COPD Discharge Info Overall Rating Care Transitions CTM_3 Clostridium difficile Infection (C diff) CDI Methicillin-Resistant Staphlococcus aureus Bacteremia MRSA Elective Delivery PC-01 *New for FFY 2021 (October 1, 2020 September 30, 2021) 7
8 Value-Based Purchasing FFY 2018 Value-Based Purchasing FFY 2022 Newly Finalized Clinical Outcomes Efficiency and Cost AMI 30 Day MORT-30-AMI HF 30 Day MORT-30-HF Pneumonia 30 Day MORT-30-PN Complication Rate With Nurses With Doctors Responsiveness About Medicines Clean and Quiet Central Line- Associated Blood Stream Infections (CLABSI) HAI-1 Catheter-Associated Urinary Tract Infection (CAUTI) HAI-2 Pooled Surgical Site Infection Colon and Abdominal Hysterectomy SSI Medicare Spending Per Beneficiary SPP-1 COPD 30 Day MORT-30-COPD CABG 30 Day MORT-30-CABG Discharge Info Overall Rating Care Transitions CTM_3 Clostridium difficile Infection (C diff) CDI Methicillin-Resistant Staphlococcus aureus Bacteremia MRSA *New for FFY 2021 (October 1, 2021 September 30, 2022) 8
9 Value-Based Purchasing FFY 2018 Value-Based Purchasing FFY 2023 Newly Finalized Clinical Outcomes Efficiency and Cost AMI 30 Day MORT-30-AMI HF 30 Day MORT-30-HF Pneumonia 30 Day MORT-30-PN Complication Rate With Nurses With Doctors Responsiveness About Medicines Clean and Quiet Central Line- Associated Blood Stream Infections (CLABSI) HAI-1 Catheter-Associated Urinary Tract Infection (CAUTI) HAI-2 Pooled Surgical Site Infection Colon and Abdominal Hysterectomy SSI Medicare Spending Per Beneficiary SPP-1 COPD 30 Day MORT-30-COPD CABG 30 Day MORT-30-CABG Discharge Info Overall Rating Care Transitions CTM_3 Clostridium difficile Infection (C diff) CDI Methicillin-Resistant Staphlococcus aureus Bacteremia MRSA Patient and Adverse Events - PSI 90 *New for FFY 2021 (October 1, 2022 September 30, 2023) 9
10 Acute Inpatient PPS VBP Priority Weighting Federal Fiscal Year And Subsequent Years Percent of Program 1.00% 1.25% 1.50% 1.75% 2.00% 2.00% Contribution Process of Care 70% 45% 20% 10% 5% Removed Patient Outcome 25% 30% 40% Clinical Care 25% 25% 20% 25% 30% 30% 30% 25% 25% 25% Efficiency and Cost 20% 25% 25% 25% 10
11 Value-Based Purchasing FFY 2018 Value-Based Purchasing FFY 2021 Newly Finalized Clinical Outcomes Efficiency and Cost AMI 30 Day MORT-30-AMI HF 30 Day MORT-30-HF Pneumonia 30 Day MORT-30-PN Complication Rate With Nurses With Doctors Responsiveness About Medicines Clean and Quiet Central Line- Associated Blood Stream Infections (CLABSI) HAI-1 Catheter-Associated Urinary Tract Infection (CAUTI) HAI-2 Pooled Surgical Site Infection Colon and Abdominal Hysterectomy SSI Medicare Spending Per Beneficiary SPP-1 COPD 30 Day MORT-30-COPD Discharge Info Overall Rating Care Transitions CTM_3 Clostridium difficile Infection (C diff) CDI Methicillin-Resistant Staphlococcus aureus Bacteremia MRSA Elective Delivery PC-01 *New for FFY 2021 (October 1, 2020 September 30, 2021) 11
12 Performance and Baseline Periods for the FFY 2021 VBP Program Domain Measure Baseline Period Clinical Care Outcomes Efficiency & Cost CAUTI, CLABSI, SSI, CDI, MRSA AMI, HF, COPD 30 day mortality Jan 1, 2017 Dec 31, 2017 July 1, 2011 June 30, 2014 PN 30 day mortality July 1, 2012 June 30, 2015 Complications April 1, 2011 March 31, 2014 Jan 1, 2017 Dec 31, 2017 Performance Period Jan 1, 2019 Dec 31, 2019 July 1, 2016 June 30, 2019 Sept 1, 2017 June 30, 2019 April 1, 2016 March 31, 2019 Jan 1, 2019 Dec 31, 2019 Patient & Caregiver Centered Experience of Care/Care Coordinator Jan 1, 2017 Dec 31, 2017 Jan 1, 2019 Dec 31,
13 Next in series Medicare Value Based Purchasing 201
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