Stable performance? Then you're losing ground in Value-Based Purchasing
“Even if you’re on the right track, you’ll get run over if you just sit there.” – Will Rogers
Though the witty philosopher-of-the-people Will Rogers spoke these words decades ago, the advice could easily have been meant for healthcare providers today. By design, the Centers for Medicare & Medicaid Services will reward approximately half of the hospitals in the country with higher Medicare reimbursement under the Value-Based Purchasing (VBP) payment methodology, with the other half seeing DRG rates decline because of lower relative performance on care process measures and H-CAHPS.
While the calculation of a hospital’s VBP score is rather complicated, two straight-forward facts are easy to understand and important to heed. First, an institution’s absolute score is somewhat meaningless until it is compared to how other hospitals in the country performed. VBP reimbursement is based on the relative value a hospital delivers compared to other providers.
And second (tipping our hat, as it were, to Will Rogers), if recent trends hold, hospitals that maintain consistent performance will be “run over.” The overall trajectory in both care process and H-CAHPS scores is upward, leaving institutions that are not improving at an increasing disadvantage. This point was emphasized by Jan Gnida, the Director of CAHPS for Professional Research Consultants, at the group’s annual “Excellence in Healthcare” conference earlier this month. The slide below from Jan’s presentation makes this point graphically for several key H-CAHPS component measures.
Steadiness may be a laudable virtue in some aspects of life, but for success in Value-Based Purchasing, institutions must consistently improve performance just to stay even with the pack. Organizations that have developed a culture of continuous improvement will be best-positioned to effectively deal with VBP – and the other challenges that will likely confront healthcare providers over the next several years.
