A new initiative has been released by the HHS (Department of Health and Human Services) which rewards hospitals for quality of care given to Medicare beneficiaries, a move which should bring down health care costs, the HHS and CMS (Centers for Medicare and Medicaid Services) announced yesterday.

Through the Hospital Value-Based Purchasing program, 3,500 hospitals around the USA will receive payments for quality provided in inpatient acute care services, rather than quantity. The program was authorized by the Affordable Care Act.

According to the HHS, this move will help acheive the aims of the Partnership for Patients, a partnership involving public and private bodies to improve the affordability, safety and efficacy of health care for all citizens. There is the potential to save up to $30 billion in health costs, as well as 60,000 lives within three years – and possibly a $50 billion savings over a decade.

HHS Secretary Kathleen Sebelius, said:

“Changing the way we pay hospitals will improve the quality of care for seniors and save money for all of us. Under this initiative, Medicare will reward hospitals that provide high-quality care and keep their patients healthy. It’s an important part of our work to improve the health of our nation and drive down costs. As hospitals work to improve their performance on these measures, all patients – not just Medicare patients – will benefit.”

Approximately $850 million will be assigned in 2013 to hospitals according to their overall performance. Performance will be measured according to a set of requirements that have proven to improve patient satisfaction and clinical processes.

The financing will come from money saved by Medicare on what it would have spent. The fund will gradually grow in size, with payments being granted according to performance.

HHS Secretary Kathleen Sebelius said:

“Medicare is in a unique position to reward hospitals for improving the quality of care they provide,” said HHS Secretary Kathleen Sebelius. “. Under this new initiative, we will reward hospitals for delivering high-quality care, treating their patients with respect and compassion, and ensuring they have the opportunity to participate in decisions about their treatment.”

Included among the measure are:

  • Whether heart attack patients get care within 90 minutes
  • Whether heart failure patients when being discharged receive instructions
  • Whether hospitals have a high level of hygiene and maintain their facilities well
  • Whether patients who underwent surgery received care within 24-hours to prevent blood clots

This will be determined on how closely hospitals adhere to best known clinical practices. Patients’ ratings of experiences of care will also be closely monitored. Following proven best practices improves patient outcomes and reduces their risk of complications, as well as significantly bringing down health care costs.

The higher quality measures a hospital receives, the more money it will get from Medicare. HHS and CMS say that the measures included in the Hospital Value-Based Purchasing program for 2013 have been endorsed by experts from around the country, including the National Quality Forum.

Written by Christian Nordqvist