The Centers for Medicare & Medicaid Services (CMS) issued its notice of proposed rules for hospital value-based purchasing (VBP).  Under the Patient Protection and Affordable Care Act (PPACA or Health Care Reform), the U.S. Department of Health and Human Services must establish a hospital VBP program for hospital payments beginning in 2013. This program must be based upon hospital performance measures from 2012 that are part of the hospital inpatient quality reporting program (formerly known as RHQDAPU).

CMS proposes that hospital performance be measured by the higher of an achievement score in the performance period or an improvement score. This would be determined by comparing the hospital’s score in the performance period with its score during a baseline period of performance.  CMS would then calculate a total performance score (TPS) for each hospital by combining its scores on all of the measures within each domain, multiplying its performance score on each domain by the proposed weight for the domain, and adding the weighted scores for the domains.

Highlights of proposed rules for 2013 include:

• 17 clinical process of care measures; and
• Eight measures from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

For 2014, CMS proposes:

• Three mortality outcome measures (during an 18-month performance period);
• Eight hospital-acquired condition measures; and
• Nine Patient Safety Indicators and Inpatient Quality Indicators.

The proposed rules will be on display at the Federal Register.