Hospital Value-Based Purchasing

The Official Website for the Medicare Hospital Value-based Purchasing Program

This website will be CMS' official source of information about the Hospital Value-based Purchasing (HVBP) Program for hospitals, clinicians, and other stakeholders who share CMS' commitment to transforming the quality of hospital care by realigning hospitals' financial incentives to do so. 

Check back often for more resources to help your organization launch this ground-breaking new program.

To learn more about what the HVBP Program is, and how it can impact you, please read the links within and outside CMS, below.

HVBP News

Members Named to HVBP Monitoring and Evaluation Strategies Technical Expert Panel (01-15-13)

Fifteen healthcare professionals from across the country have been named to participate in the Hospital Value-based Program (HVBP) Monitoring and Evaluation Strategies Technical Expert Panel. For more details, see Downloads below.

Payment Adjustments

CMS Publishes HVBP-based Incentive Payment Adjustment Factors for FY 2013 (12-20-12)

CMS continues implementation of the HVBP Program in the Fiscal Year 2013 Inpatient Prospective Payment System (IPPS) rule. In that final rule, CMS finalized the methodology to calculate the value-based incentive payment adjustment factor and what portion of the IPPS payment will be subject to the adjustment factor (see 77 FR 53573-76). For more information on these  payment-related policies, please refer to the FY 2013 IPPS Final Rule in the “Related Links” section below.  

The value-based incentive payment adjustment factors for the FY 2013 payment adjustments under the Hospital VBP Program can be found in the “Downloads” section below. TIP: The listing of payment adjustment factors is organized by CMS Certification Number (CCN). If you are unsure of your hospital's CCN, please visit the CCN listing at https://data.medicare.gov/dataset/Hospital-General-Information/v287-28n3. 

Regulations and Notices

CMS Finalizes Program Provisions for FYs 13, 15, and 16 of HVBP (8-1-12)

On August 1, CMS announced the final rule for the Inpatient Prospective Payment System, which included a number of finalized policies related to the Hospital VBP Program. Specifically, we finalized important operational details for FY 2013, which is the first year in which value-based incentives are available under the Program. We also finalized new policies for FY 2015, including: 1) new measures; 2) grouping and scoring in four domains; 3) applicable minimum numbers of cases for measures; 4) performance standards; and 5) domain weighing for FY 15 Total Performance Scores.

The rule also finalized new provisions for the FY 2016 payment year, which align the HVBP Program with the National Quality Strategy and its priorities of better patient outcomes, quality, safety, and lower cost with Medicare payment.

A fact sheet to describe the provisions of the final rule, along with a link to the final rule itself, are available in the "Related Links" section, below. The final rule was issued in the Federal Register on August 31, 2012, as part of the Agency's Inpatient Prospective Payment System proposed rule.

CMS Final Rule for FY 2014 Hospital VBP Program (11-1-11)

On November 1 , 2011, CMS released its final rule for the FY 2014 Hospital VBP Program as part of the Agency's Outpatient Prospective Payment System final rule. See the "Related Links" section for more information about the rule, including the provisions specific to Hospital VBP. This final rule was published in the Federal Register on November 30, 2011.

Conference Calls/Webinars

National Provider Call: FY 2013 Actual Percentage Payment Summary Report (10-4-12)

On October 4, 2012, CMS hosted a National Provider Call for hospitals and other stakeholders from 1:30 - 3:00 pm EST. During this call, CMS discussed the Actual Percentage Payment Summary Report as well as important operational details about FY 2013--the first year in which the value-based incentive payments will be made under the HVBP program. CMS also discussed a review and corrections process as well as an appeals process for the program.

A copy of the slide presentation for this call is available in the "Downloads" section, below.

National Provider Call: FY 2014 Program Overview (7-11-12)

On July 11, 2012, CMS hosted a National Provider Call for hospitals and other stakeholders from 1:30 - 3:00 pm EST. During this call, CMS gave an overview of the FY 2014 program, with particular emphasis on highlighting the differences between the FY 2013 and FY 2014 programs. Focus on the new "Outcomes" domain for FY 2014 scoring was included. 

A copy of the slide presentation for this call is available in the "Downloads" section, below.

National Provider Call: FY 2013 Hospital VBP Dry Run (2-28-12)

On Tuesday, February 28, 2012, CMS hosted a National Provider call for hospitals from 1:30 - 3:00 pm EST. During this call, CMS discussed the HVBP FY 2013 Dry Run. Slides for the call, as well as a transcript of the call, are available in the "Downloads" section, below.

Special Open Door Forum: Hospital VBP FY 2013 Program (7-27-11)

On Wednesday, July 27, 2011, CMS hosted a special Open Door Forum on the Hospital VBP. This forum will focus on understanding the finalized proposals for the FY 2013 Program, under which performance and quality of care factor into how much Medicare pays hospitals. This ODF is particularly timely for hospitals, since the period of performance for the FY 2013 program began on July 1, 2011.

To read the slide deck CMS used during this forum, please see the "Downloads" section, below.

Medicare Spending per Beneficiary Measure

Fact Sheet: Spending per Hospital Patient with Medicare (December 2012)

In the "Downloads" section, below, CMS has posted a document designed to help readers understand the Medicare spending per beneficiary measure.  Specifically, it describes the data displayed on the "Spending per Hospital Patient with Medicare" web page, part of the Hospital Compare site.

Reliability Analysis of Medicare Spending per Beneficiary Measure

The "Downloads" section, below, includes an analysis that documents the reliability of the Medicare Spending per Beneficiary measure, including the methodology used to determine measure reliability.

Other HVBP Measures

Reliability Analysis of Hospital VBP Measures

CMS engaged Mathematica Policy Research, an independent contractor, as part of its efforts to help shape the Hospital VBP Program. To provide background for CMS' policy decisions, Mathematica analyzed the reliability of selected measures of hospital quality that will be used for Hospital VBP, focusing on the relationship between measure reliability and the length of the discharge period. In this context, "measure reliability" is defined as the extent to which variation in the measure is due to variation in the quality of care rather than random variation due to the sample of cases observed.

To read Mathematica's analysis, please click the link in the "Downloads" section, below.

Misc. Program Resources

HVBP Frequently Asked Questions

CMS is collecting "Frequently Asked Questions" obtained from inquirers through our National Provider Calls, Open Door Forums, and other sources. Our most recent FAQ document is available in the "Downloads" section, below.