CMS released fiscal year 2020 Hospital Value-based Purchasing Program results on Oct. 29.
Program performance affects Inpatient Prospective Payment System reimbursement to about 2,700 U.S. hospitals.
Five notes on hospitals' performance:
1. Hospitals improved their average total performance score. Each hospital receives a total performance score based upon hospital performance scores in clinical outcomes, safety, person and community engagement, and efficiency and cost reduction. For fiscal year 2020, the average total performance score climbed to 38.5 from 38.1 the year prior.
2. Rural hospitals, on average, did better than urban hospitals in the safety, person and community engagement, and efficiency and cost reduction domains, while urban hospitals did well in the clinical care category. The average total performance score across rural hospitals was 42.8 — greater than the national average total performance score.
3. More than 1,500 hospitals (more than 55 percent) will see an increase in their Medicare payments for inpatient stays for fiscal 2020. The average net payment adjustment is 0.16 percent, and the average net increase in payment adjustments among hospitals that will receive a pay bump is 0.61 percent. The highest performing hospital in fiscal 2020 will receive a 2.93 percent net increase in payment.
4. Most hospitals (60 percent) will see a payment change between -0.5 and 0.5 percent in their Medicare payments for fiscal 2020.
5. Medicare IPPS payments are based on the quality and cost of inpatient care hospitals provide. For the incentive payments, CMS withholds and redistributes 2 percent of the payments for hospitals participating in the value-based purchasing program based on their performance on quality and cost measures. CMS estimates that about $1.9 billion is the total amount that will be available for incentive payments in fiscal 2020.
Emily Rappleye contributed to this report.
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