Should We Continue the Hospital Value Based Purchasing Program Response

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**Post need response and one question to the writer. Should we continue the Hospital Value-Based Purchasing program? The Hospital Value-Based Purchasing (VBP) program is one of the federally mandated regulations that is a part of the Affordable Care Act (ACA) (Lee et al., 2019). The United States, (U.S.) among other developed nations globally, ranks number one for health care spending, but ranks the lowest of developed countries in health care performance and outcomes. The purpose of this program is to encourage hospitals and administrators to improve in four categories: clinical approach, patient outcomes, patient experiences and efficiency (Lee et al., 2019). Before, the U.S. health care system relied on fee-based services, regardless of patient outcomes or quality of care. With the launch of the program, there was some skepticism that VBP would be effective, but also bias, that well-off hospital systems would be unfairly rewarded due to financial advantages (Chee et al., 2016). The purpose of the VBP is to assess and analyze opportunities through strengths and weaknesses, reducing health disparities, establishing measurement outcomes and improving quality (Chee et al., 2016). The question at hand and being proposed is are hospitals really thriving and sustaining financially under the VBP? According to the authors Chee et al. (2016), the VBP is meant to play a significant role in the future of healthcare delivery systems, and provide a basic infrastructure for valueoriented care. In 2019 alone, Medicare paid out $1.9 billion dollars in incentives to qualifying hospital systems (LaPointe, 2019). According to the author LaPointe (2019), 55% of hospitals participating in the VBP will see Medicare reimbursements due to a quality of inpatient care provided. The remaining 45% will either not see a change in Medicare payment or fall within the threshold of the affected 4% with penalties. In contrast, VBP has been reported by many physicians to be complex, and providers report that measures are overly complex and contradictory (Chee et al., 2016). Under the ACA, up to 4% of Medicare payments were affected and dependent upon negative patient experiences, and up to 9% of payments by 2022 are in play (Chee et al., 2016). Some skeptics state that hospitals in poverty-stricken regions, are likely to face higher health disparities (Chee et al., 2016). These areas are reported to have lower financial means and higher illiteracy rates. When discussing the patients’ ability to report satisfaction, these socioeconomic outliers could affect VBP programs. In 2010, when the first findings of the program were published, physicians in the lowest quartile of performing hospitals, had the greatest improvement than those of the highest quartile, meaning a marginal improvement in patient experience and clinical quality (Chee et al., 2016). In 2016, Medicaid programs showed that VBP programs improved the overall quality of care (LaPointe, 2019). Authors Chee et al. (2016), stated that VBP is on the right track, but does need to adjust incentives, increase feedback and have more focused clinician feedback. What this essentially means, is as a hospital system performs well, larger incentives need to be incorporated to continue to uphold the quality. Also more detailed and continous feedback is needed for areas of improvement, and individual physician assessments are needed instead of whole departments. References Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). Current State of ValueBased Purchasing Programs. Circulation, 133(22), 2197-2205. doi:10.1161/circulationaha.115.010268 Lee, S. J., Venkataraman, S., Heim, G. R., Roth, A. V., & Chilingerian, J. (2019). Impact of the value‐based purchasing program on hospital operations outcomes: An econometric analysis. Journal of Operations Management, 66(1-2), 151-175. doi:10.1002/joom.1057 LaPointe, J. (2018, December 03). 55% of Hospitals Earn Incentive in Value-Based Purchasing Program. Retrieved June 01, 2020, from https://revcycleintelligence.com/news/55-ofhospitals-earn-incentive-in-valuebased-purchasing-program
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I do not believe neither do I support the use and application of Value-Based
Purchasing in the health care facilities. It is mainly because I believe that, just as
explained in your article, that it will only favor the well-off hospitals. With the VBP,
quality will be qu...


Anonymous
I was having a hard time with this subject, and this was a great help.

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