Value-Based Purchasing, VBP, health care, Centers for Medicare and Medicaid Services, CMS, Affordable Care Act 2010
This is an initiative by the Centers for Medicare and Medicaid Services (CMS) that is meant to reward or punish acute-care health centers through incentives payments depending on the care quality given to beneficiaries of Medicare. It was authorized by the Congress under the Affordable Care Act 2010. According to the National Business Coalition on Health, the Value-Based Purchasing could be described as a strategy of the demand side for measuring, reporting and rewarding excellence in delivery of health care. It involves the actions of health plans, coalitions, individual consumers, or employer purchasers as they decide on; accessibility, quality, price, incentives alignment and efficiency.
[...] According to the National Business Coalition on Health, the Value-Based Purchasing could be described as a strategy of the demand side for measuring, reporting and rewarding excellence in delivery of health care. It involves the actions of health plans, coalitions, individual consumers, or employer purchasers as they decide on; accessibility, quality, price, incentives alignment and efficiency. The health care providers who are most effective are rewarded by improved reputation which is made known through reporting to the public, differential reimbursements, or increase in market share as a result of consumer, purchaser or payer selection. [...]
[...] This in turn catalyzes restructuring of the health care into a value-driven operation, improving quality and reducing costs (NBCH, 2011). Elements of the VBP There are several elements of the VBP. First is the performance measurement that is standardized. It is important to measure performance before rewarding health care providers with public recognition, consumer selection or differential payments. Measurement of performance should be done at different levels such as; hospitals, physician groups, health plans, or individual practitioners of health care. [...]
[...] References National Business Coalition on Health (NBCH). (2011). Value-Based Purchasing: A Definition. National Business on Health's Value-Based Purchasing Council Guide. Warner, R.M. and Dudley, R.A. (2012). Medicare's New Hospital Value-Based Purchasing Program is Likely to Have Only a Small Impact on Hospital Payments. Health Aff: Millwood. [...]
[...] The choices include; lifestyle decisions, personal preference for treatment, selection of the providers of health care and treatment compliance. Proper incentive programs, counseling, information dissemination and coaching should motivate consumers towards choosing better performance in the health care system. It is important for consumers to make informed choices and this can be done through; community based or employer programs which encourage the consumer to keep a healthy lifestyle to avoid hospitals; dissemination of information through proper channels and having a value- based insurance design (NBCH, 2011). [...]
[...] The third element entails payment innovation. There should be a successful payment method that reimburses providers depending on their performance and one that fashions methods of payment to be aligned with economic incentives that give desired outcome. Differential payment is meant to promote quality of services. The service providers are reimbursed for keeping patients in good health rather just keeping them well. The payment should also include clinical or social determinants of good health (NBCH, 2011). The last element entails consumers making informed choices. [...]
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