Medicare Value Based Purchasing Program - Research Paper Example

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Medicare Value Based Purchasing Program 13-03-12 Medicare Value Based Purchasing Program Introduction: The term “Value Based Purchasing Program” refers to a set of programs designated at providing varying Medicare payment levels on the basis of the quality and efficiency of the Medicare providers…
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Download file to see previous pages The implementation of separate value based purchasing programs for each of the different Medicare providers requires more than just trumpeting the program. The program has different payment levels and efficiency measuring strategies for hospitals, physicians and other practitioners, home health agencies, ESRD providers and facilities, and skilled nursing facilities. (Reichard 2009). The Policy: The Medicare Value based purchasing programs have been formulated in an effort to facilitate the transformation of the Medicare system from a passive payer of claims to an active purchaser of care. The operational infrastructure of RHQDAPU as established by the CMS has been used as a base for the development of Medicare Value based purchasing programs which includes the following provisions: i. As specified by the President’s FY2006 and FY2007 budgets, the value based purchasing programs are budget neutral and are formulated in accordance with the policy recommendations of Institute of Medicine (IOM) and Medicare Payment Advisory Commission (MedPAC). ii. The existing Medicare performance measurements and reporting infrastructure together with RHQDAPU components have been used as a foundation for the structure of Value Based Purchasing Programs. iii. ...
In accordance with the provisions of Patient Protection and Affordable Car Act of 2010, the data collected in the initial year would be utilized in informing the concerned medical individuals about their incentive payments. v. The implementation and coordination of VBP program would be undertaken by CMS, which will also monitor the effectiveness of the program through consensus processes such as Hospital Quality Alliance (HQA), National Quality Forum (NQF), and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). vi. The reporting requirements specified in Division B, Title 1, Section 109 of Tax Relief and Healthcare Act will be utilized by VBP programs for the measurement of performance and the calculation of incentive payments. vii. The VBP programs will undertake the responsibility of eliminating existing disparities in the health care system. The enforcement of the Value based purchasing programs would not be undertaken without the consent of the concerned medical personnel. viii. A withholding up to 2% of total payments pertaining to specific Medicare providers would be utilized in the evaluation of the incentive pool. All funds collected under the value based purchasing programs will be offered as incentive payments to the eligible participants will not be changed over time. (U.S. Department of Health and Human Services 2007). Models of VPB Programs: The value based purchasing programs are composed of three models which are listed as follows: Model 1: Single Large Purchaser: This involves a large active Medicare supplier which is working collaboratively with other suppliers. If reward incentives are targeted at these individuals then inevitably the overall performance of the health care system as a whole will ...Download file to see next pagesRead More
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