WASHINGTON – The Department of Health and Human Services has launched a new initiative aimed at rewarding hospitals for the quality of care they provide to people with Medicare while reducing healthcare costs. The measures to determine quality in the Hospital Value-Based Purchasing Program focus on how closely hospitals follow best clinical practices and are underpinned by the use of health information technology.

 

The Hospital Value-Based Purchasing program is a marked change in how Medicare pays healthcare providers and facilities. For the first time, 3,500 hospitals across the country will be paid for inpatient acute care services based on care quality, rather than on the quantity of the services they provide.

 

The initiative helps support the goals of the Partnership for Patients, a new public-private partnership that aims to improve the quality, safety and affordability of healthcare. The Partnership for Patients has the potential over the next three years to save 60,000 lives and up to $35 billion in healthcare costs, including up to $10 billion for Medicare, according to the government. Over the next 10 years, the Partnership for Patients could reduce costs to Medicare by about $50 billion and result in billions more in Medicaid savings.

 

 “Changing the way we pay hospitals will improve the quality of care for seniors and save money for all of us,” said HHS Secretary Kathleen Sebelius. “Under this initiative, Medicare will reward hospitals that provide high-quality care and keep their patients healthy. It’s an important part of our work to improve the health of our nation and drive down costs. As hospitals work to improve their performance on these measures, all patients – not just Medicare patients – will benefit.”

 

In FY 2013, an estimated $850 million will be allocated to hospitals based on their performance on a set of quality measures that have been shown to improve clinical processes of care and patient satisfaction. This funding will be taken from what Medicare otherwise would have spent, and the size of the fund will gradually increase over time, resulting in a shift from payments based on volume to payments based on performance.

 

“Medicare is in a unique position to reward hospitals for improving the quality of care they provide,” said Centers for Medicare & Medicaid Services Administrator Donald Berwick, MD. “Under this new initiative, we will reward hospitals for delivering high-quality care, treating their patients with respect and compassion, and ensuring they have the opportunity to participate in decisions about their treatment.”

 

Some of these measures will assess whether hospitals:

·      Ensure that patients who may have had a heart attack receive care within 90 minutes;

·      Provide care within a 24-hour window to surgery patients to prevent blood clots;

·      Communicate discharge instructions to heart failure patients; and

·      Ensure hospital facilities are clean and well maintained.