Monday, November 26, 2012

Affordable Care Act’s Value-Based Purchasing Summary Reports Available: but not to the Public

Here’s a Press Release from King & Spaulding announcing the VBP scores the Government will be calculating for each hospital as required by ACA.  The scores will rank your community’s Hospital on a Quality Score that will by the government to reduce the Medicare reimbursement to your hospital. 

Per a comment from local Healthcare guru CSteven Tucker, the Independent Payment Advisory Board will get these scores, and can use them for the algorithms they’ll build defining just what’s “quality” healthcare, but everyday citizens trying to make their own decisions won’t have access.

Just another murky and secretive feature of ACA that those folks funded by AARP at Illinois Health Matters ought to come clear on to the public.

Below, per King & Spaulding (link follows),

On November 7, 2012, CMS posted notice announcing that actual percentage payment summary report for fiscal year (FY) 2013 Hospital Value-Based Purchasing (VBP) program was available on its QualityNet website.  The report provides information to FY 2013 VBP Program participating hospitals of their actual, as opposed to estimated, Total Performance Score (TPS) and incentive payment adjustment for the first year of the VBP program.  Hospitals must request a recalculation of their performance scores on each condition, domain, and TPS within 30 calendar days of the date on which their Value-Based Percentage Payment Summary Report is posted on QualityNet.  An adverse determination from CMS on such recalculation request is a prerequisite to appeal.  Therefore, failure to request recalculation within 30 days of posting on QualityNet will result in waiver of any future appeal of those issues.

CMS’s notice is available here.

CMS Issues Notice That Value-Based Purchasing Summary Reports for FY13 Are Now Available | King & Spalding - JDSupra

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