CMS implements programs targeting hospital readmissions and quality of care

On Oct. 1, the Centers for Medicare & Medicaid Services (CMS) implemented two new programs under the Affordable Care Act. The Hospital Value-Based Purchasing Program emphasizes quality of care in the hospital setting by shifting toward a pay-for-performance model. Under the new program, Medicare will withhold 1 percent of reimbursements to acute-care hospitals and redistribute these funds to hospitals that meet high performance standards. The redistributed funds for the value-based purchasing program this year are projected to be about $850 million.

The Hospital Readmissions Reductions Program incentivizes low readmissions rates by penalizing hospitals that have too many patient readmissions within 30 days of discharge. Initially, hospitals readmission rates will be measured on three conditions: heart attack, heart failure; and pneumonia. Early predictions of the impact of this program estimate that approximately two-thirds of U.S. hospitals will receive reduced payments as a result of this new program. 

In Brief

  • CMS contractors have begun issuing incentive payments for the 2011 Electronic Prescription (eRx) Incentive Program.  Providers who participated in the eRx program will receive their incentive payment in the next few weeks. 
  • Registration will close on Fri, Oct. 19 for the Round 1 Recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.  Visit the competitive bid website for registration information.
2012-10-02T00:00:00+00:00 October 2nd, 2012|Clinical Resources|