March 22, 2011 11:39 ET

VHA Inc. Sends Comment Letter on Value-Based Purchasing Program to the Centers for Medicare and Medicaid Services

IRVING, TX--(Marketwire - March 22, 2011) - VHA Inc., the national health care network, has sent an official comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding the hospital inpatient value-based purchasing (VBP) program. In the letter, VHA expressed support and appreciation for CMS' efforts to reward hospitals for meeting quality of care standards and encouraging and rewarding continued improvements over baseline performance, but also recommended several changes to the program.

Beginning Oct. 1, 2012, Medicare will link financial payments to hospitals to quality outcomes and patient perceptions of care under a VBP program. Hospitals that do not surpass CMS-mandated performance targets for five clinical conditions and for ratings reflecting patients' perspectives on care, measured through the HCAHPS survey, will be subject to penalties and could lose millions of dollars in Medicare reimbursements.

"While we applaud CMS for outlining efforts to reward hospitals for continued quality of care improvements, VHA is recommending that CMS re-examine the weighting for the value-based purchasing program's performance incentive payments," said Ed Goodman, vice president of public policy for VHA. "Although patient experience is an important component of value, regional and cultural factors appear to make it very difficult for certain hospitals to score well on the HCAHPS survey, and we recommend that the CMS take this into consideration and consider changing the HCAHPS weighting."

The letter also outlined VHA's recommendation that the VBP clinical quality scores should only factor in quality metrics that hold the greatest potential to improve quality of care and patient outcomes and activities that hospitals can reasonably be expected to influence. For example, the hospital may do everything correctly to ensure that a patient receives the proper blood type during transfusion, but if the blood bank the hospital relies on for blood mislabels the bag, the hospital could be unfairly punished for an outcome it could not control.

Furthermore, VHA also encourages CMS to partner with the larger health care industry to refine the number of total measures that could be eventually included in the VBP program. CMS has publicly acknowledged that several measures may not be ready yet for performance measurement, but hospitals could be accountable for as many as 50 measures by 2014.

VHA is currently working closely with its member health care organizations through its Value Insurance Program, launched in May 2010, to prepare hospitals to succeed in the VBP environment.

VHA's approach to clinical performance improvement that focuses on the proven benefits of rapidly adapting leading clinical practices through context-based design principles that fit each hospital's unique environment, instead of promoting idealized models that rely on a one-size-fits-all approach, is proving to benefit members and help them improve their performance. 

View VHA's other recommendations and the full letter to CMS on

About VHA
VHA Inc., based in Irving, TX is a national network of not-for-profit health care organizations that work together to drive maximum savings in the supply chain arena, set new levels of clinical performance and identify and implement best practices to improve operational efficiency and clinical outcomes. In 2009, VHA delivered record savings and value of $1.47 billion to members. Formed in 1977, VHA serves nearly 1,350 not-for-profit hospitals and more than 30,000 non-acute care providers nationwide, coordinating delivery of its programs and services through its 16 regional offices. VHA has been listed as one of the best places to work in health care by Modern Healthcare since 2008 and one of the best places to work in IT by Computer World since 2007.

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