Hospital earns CMS incentive bonuses

Daviess Community Hospital among the best in treating Medicare patients.




The Centers for Medicare & Medicaid Services (CMS), the federal agency that runs Medicare, is changing the way Medicare pays for hospital care by rewarding hospitals for delivering services of higher quality and higher value.

Daviess Community Hospital is among the best performing hospitals in the US for treating Medicare patients with high quality, efficient care, earning incentive bonus payments from the Centers for Medicare and Medicaid Services (CMS). The payments are part of the federal 2016 Hospital Value Based Purchasing (VBP) Program, which is distributing $1.5 billion in incentive payments to qualifying hospitals. Fewer than one-third of all hospitals will be receiving bonus payments.

The VBP program rewards acute-care hospitals with incentive payments for providing high quality care to Medicare patients, including how closely they follow best clinical practices and how well they enhance the patient experience during hospital stays. The program’s calculation is 50% clinical outcomes and processes, and 50% efficiency and patient experience. Established under the Affordable Care Act, the VBP program encourages hospitals to provide the best care by adjusting reimbursement payments based on the quality of that care.

Among the 87 Indiana Hospitalsparticipating, Daviess Community Hospital ranked #13 best in the State of Indiana and #2 in Southwest Indiana for their results with Medicare’s “Pay for Performance” quality program.

“Our top priority is to provide our patients with safe, high-quality care,” said David Bixler, CEO, Daviess Community Hospital. “We are committed to providing excellent care and our entire team is working every day to ensure that every patient has the best possible experience and outcome.”

Funded by a 1.75 percent reduction – up from 1.5 percent last year – from participating hospitals’ group payments, the VBP redistributes the payments based on the hospitals’ Total Performance Scores. The actual amount each hospital earns depends on the range and distribution of all eligible/participating hospitals scores. It is possible for a hospital to earn back an incentive payment that is less than, equal to, or more than the reduction for that year. The best performing hospitals’ incentive payments will be paid for from the reductions of poor performing institutions. Daviess Community Hospital will recoup all of the 1.75% and receiving incentive bonus payments.

“Data indicates Daviess Community Hospital is experiencing a positive change in the federal government’s pay for performance programs,” says Doug Leonard, president of the Indiana Hospital Association. “These results mean the hospital is improving care and outcomes for patients. This type of change happens when hospital leaders, doctors, nurses and other health care providers collaborate together for the sake of the patients and the community served.”

According to the CMS website, the Hospital VBP Program is part CMS’ long-standing effort to structure Medicare payments in a way that improves healthcare quality. This is the fourth year of value-based purchasing for the largest share of Medicare spending, affecting payment for inpatient stays in over 3,000 hospitals across the country. CMS states that it now pays hospitals for inpatient acute care services based on the quality of care, not just the quantity of services provided. CMS has been increasing the program’s number of quality domains and measures used to evaluate performance, with the goal of “a broader, richer set of measures over time and aligning with the National Quality Strategy (NQS).”