Hospital executives preparing for value-based Medicare payments
Nearly three-quarters of physician leaders said their organizations are preparing for changes in the way hospitals are reimbursed for treating Medicare patients, according to a new poll.
From Feb. 12 to 16, 656 executives responded to a poll conducted by the American Association for Physician Leadership, an organization with more than 11,000 members from 46 countries.
Of the respondents, 73 percent said they were trying to meet the goals of the Hospital Readmissions Reduction Program and the Hospital Value-Based Purchasing Program, which were both established as part of the Patient Protection and Affordable Care Act. In addition, 15 percent said they were not attempting to meet the goals, while 12 percent said the programs were not applicable for their organization.
Under the Hospital Readmissions Reduction Program, acute care hospitals can have their Medicare payments reduced for having high readmission rates. The Centers for Medicare & Medicaid Services (CMS), which runs Medicare, defines readmissions as an admission to a hospital within 30 days of discharge from that same hospital.
CMS tracks readmissions for acute myocardial infarction, heart failure and pneumonia.
The Hospital Value-Based Purchasing Program implements a pay-for-performance system and affects approximately 3,000 hospitals. Under the program, hospitals are compared with each other as well as with their own performance in the previous year. Hospitals are measured on four domains: clinical processes of care, patient experiences, outcomes and efficiency.
Thirty percent of Medicare payments will be tied to quality or value by the end of 2016. The ratio will increase to 90 percent by the end of 2018.
“The move to value-based care is happening, and I agree the Health and Human Services’ goals are challenging,” Peter Angood, president and chief executive officer of the American Association for Physician Leadership, said in a news release. “The real key and emphasis needs to be on finding accurate and equitable measures of quality. If we don’t establish solid measurements and metrics, the new payment system will struggle and the reported outcomes will be uncertain.”
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.