Health Affairs July 10, 2023
In its Proposed Rule released in May 2023, The Centers for Medicare and Medicaid Services (CMS) put forward a significant change to the Hospital Value-Based Purchasing (VBP) program, a longstanding program that compares a hospital’s performance on a set of measures to performance from a full set of hospitals nationwide. Under the proposed change, hospitals serving a greater percentage of dual-eligible patients would receive an equity adjustment that increases their quality performance scores – and in turn, performance scores for the payment program overall.
While this change focuses on payments to hospitals, this proposed change echoes a similar strategy implemented in prior rulemaking among a subset of accountable care organizations (ACOs). The expansion of type of equity-adjusted approach signals policymakers’...
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