MedPAC to Congress: Consolidate Value-Based Programs

The commission also recommends better pay for higher-performing hospitals.

Chances are we’ll be hearing a lot about the Hospital Value Incentive Program in the next couple of years. That’s the name of the program that the Medicare Payment Advisory Commission (MedPAC) wants Congress to implement. It would gather Medicare’s value-based programs under one regulatory umbrella.

Modern Healthcare reports that “compared to current law it would increase spending on quality programs from $750 million to $2 billion in 2020 and by $5 billion to $10 billion over five years.”

The same performance targets will be in place that the three existing value-based programs use: mortality, spending, patient experience, hospital-acquired conditions and readmissions.

And, MedPAC argues, it would take into account that some hospitals serve sicker populations or must deal with different social determinants of health. The program would also factor in that some hospitals serve more dual-eligible Medicare and Medicaid patients.

“The program will divide hospitals into certain peer groups,” Modern Healthcare reports. “A hospital in a peer group would have roughly the same number of patients and dual eligible patients as other hospitals in the group. Those groups will have a pool of funds that will be distributed based on each hospital's HVIP score.”