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CMS Releases FY 16 Hospital Value-based Purchasing Program Results

Monday, October 26, 2015  
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CMS Releases FY 16 Hospital Value-based

Purchasing Program Results

The Centers for Medicare and Medicaid (CMS) today released the Hospital Value-based Purchasing (VBP) Program Results for the Fiscal Year 2016 (FY 16). This new program changes the Medicare Inpatient Prospective Payment System (IPPS) to one that emphasizes quality of care, rather than the quantity of services provided.

CMS has noted that in FY 2016 the applicable percent reduction will increase from 1.50 percent to 1.75 percent of the base operating Medicare Severity diagnosis-related group (MS-DRG) payment amounts. CMS says that in FY 2016, more hospitals will see an increase in their base operation MS-DRG payments, rather than a negative change. Further, CMS also says about half of hospitals will see a small change in their base operating MS-DRG payments, between -0.4 and 0.4 percent. The highest performing hospital will receive a change in payments of slightly above 3 percent, while the worst performing hospital will see a 1.75 reduction in payments.

For the future, CMS said that they have made changes to the quality domains for 2017 and that they have finalized a policy that requires hospitals to receive domain scores in at least 3 of the four domains in order to remain eligible for total performance score and payment adjustments.