Value Based Purchasing - VBP
Medicare Value Based Purchasing goes into effect for short term, acute care hospitals on October 1, 2011. Under the VBP program, reimbursement for all IPPS discharges will be adjusted according to a hospital's performance against a set of quality measurements. During the first year these adjustments will range from a reduction of -1.0% for hospitals with poorer performance to an increase of 1.5% for hospitals with better performance.
Total Performance Score - TPS
For FY13 there are 12 measures of clinical performance and 9 measures of patient satisfaction as published on the Hospital Compare website. A hospital's performance is measured both on performance during a measurement period and improvement above a baseline period. Scores are combined into a single Total Performance Score (TPS) that determines the adjustment to reimbursement during a full fiscal year.
Determining a hospital's TPS and its reimbursement impact
Though hospitals want to understand and manage their performance under VBP the calculations are quite complex and the necessary data to make projections are not readily available. The TPS Analyzer has been developed to simplify the process of estimating TPS scores and their reimbursement impact. Detailed data are presented to allow identifying areas where improvement may be needed.
TPS Analyzer shows each hospital's TPS, its impact, and how it compares
The TPS Analyzer is an optional app that details each hospital's TPS calculation, estimates its impact on reimbursement, and provides side-by-side comparisons with other hospitals. It is immediately available to ahd.com subscribers at a cost of $245. Please note that the TPS Analyzer is based on the most recent data available from CMS but can only provide an estimate of scores and impacts. When VBP is implemented on October 1, 2012 it will be based on later reporting periods.
For further information
Two articles were recently published in HFM, the official publication of the Healthcare Financial Management Association. These articles were authored by ahd.com experts and are the basis used in developing the TPS Analyzer:
What value-based purchasing means to your hospital, August, 2011.
Please see the AHD Apps page for ordering information and to link a sample report.