Value Based Purchasing

VBP Worksheets help you stay up to date

It can be a challenge to stay up to date with the CMS value-based purchasing (VBP) program. That's why Qualis Health developed our Model VBP Worksheets—to make it easier.

The worksheets contain the specified date ranges for baseline and performance periods, national performance standards, and embedded formulas based on what is currently available from CMS. Once you input data, the worksheet produces a point assignment and ultimately an estimated Total Performance Score (TPS) you can use to assess your current status or to set bold goals for improvement. The worksheets help keep your focus where you want it—on driving outstanding performance.

FY2013—Know Where You Stand

The performance period for FY2013 VBP ended March 31, 2012. CMS will adjust payments for Medicare discharges during FY2013 based on how acute care, PPS hospitals performed on specified process of care and patient experience measures during a designated performance period. These adjustments are referred to as incentive payments.

To fund these incentive payments, CMS will reduce the base diagnosis-related group (DRG) payment for Medicare discharges in FY2013 by 1% and redistribute those dollars according to performance as an adjustment payment. To compute the incentive payment, CMS will calculate a total performance score (TPS) for each hospital and multiply it by a “linear exchange function” which will be determined by CMS after the performance period data has been amassed.

CMS will post the incentive payment estimates to hospitals' QualityNet accounts no later than August 2012 and notify hospitals of the exact amounts by November 2012.

Hospitals can use Qualis Health's FY2013 Model VBP Worksheet to estimate their TPS for this first year of VBP; full instructions are provided in the reference guide.

FY2014—Start Monitoring Now

The second year of VBP is already underway. Are you tracking your performance?

During the second year of VBP, CMS will evaluate each PPS hospital’s performance not only on specified process of care and patient experience measures, but also on three outcome measures.

The performance period for the outcomes measures began July 1, 2011 and will end June, 30 2012. The performance period for the process of care and patient experience measures began April 1, 2012 and will end December 31, 2012.

Under FY2014 VBP, CMS will reduce the base DRG payment for Medicare discharges by 1.25% and redistribute those dollars according to each hospital’s TPS as an adjustment to discharge payments throughout the year.

Hospital can use the Qualis Health FY2014 Model VBP Worksheet to:

• Continue leadership engagement, attention, and accountability on VBP performance
• Identify priority measures for improvement along with bold goals while conduct real-time monitoring 
• Focus on areas of success to ensure processes leading to results are known and hard-wired

Full instructions are provided in the reference guide.

Idaho & Washington Performance Reports

Hospitals located in Idaho or Washington may also take advantage of Qualis Health's VBP Performance Reports. These reports are produced quarterly and delivered to designated QualityNet accounts at each hospital. Contact the appropriate quality improvement consultant (see sidebar) for information about your hospital's performance report.

Unlike the VBP Worksheets which allow hospitals to generate estimates with real-time data, the VBP performance report gives hospitals VBP estimates and in-state TPS rankings based on data available to Qualis Health. These reports are static and give hospitals a vision of what their TPS might look like using retrospective data.