C-Suite Cheat Sheet: Hospital Value-Based Purchasing

Educational Briefing for Suppliers and Service Providers

Executive Summary

The Hospital Value-Based Purchasing (VBP) Program adjusts hospital inpatient Medicare payments based off performance on a set of quality and efficiency measures. It is one of three mandatory pay-for-performance (P4P) programs that the Affordable Care Act introduced and is managed by the Center for Medicare and Medicaid Services (CMS). VBP promotes quality care delivery, positive patient experience, and cost effectiveness by factoring each of these elements into scoring. Like the other P4P programs, low-scoring hospitals see lower reimbursement rates, but VBP is the only program in which high-scoring hospitals see an increase in their Medicare reimbursements, resulting in a net neutral effect on the budget. 

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C-Suite Cheat Sheet: Bundled Payments