CMS' Value-Based Programs

What are the value-based programs?

Value-based programs reward health care providers with incentive payments for the quality of care they give to people with Medicare. These programs are part of our larger quality strategy to reform how health care is delivered and paid for. Value-based programs also support our three-part aim:

  • Better care for individuals
  • Better health for populations
  • Lower cost

Why are value-based programs important?

Our value-based programs are important because they’re helping us move toward paying providers based on the quality, rather than the quantity of care they give patients.  

What are CMS’ original value-based programs?

There are 5 original value-based programs; their goal is to link provider performance of quality measures to provider payment:

  • End-Stage Renal Disease Quality Incentive Program (ESRD QIP)
  • Hospital Value-Based Purchasing (VBP) Program
  • Hospital Readmission Reduction Program (HRRP)
  • Value Modifier (VM) Program (also called the Physician Value-Based Modifier or PVBM)
  • Hospital Acquired Conditions (HAC) Reduction Program

Are there other value-based programs?

There are other value-based programs:

  • Skilled Nursing Facility Value-Based Purchasing (SNFVBP)
  • Home Health Value Based Purchasing (HHVBP)

What's the timeline for these programs?


How do value-based programs work with other CMS quality efforts?

Page Last Modified:
09/06/2023 04:51 PM