Health Watch USA Logo Value Based Purchasing (VBP)

   
Value Based Purchasing (VBP)

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1)  Clarification of the National Quality Forum Serious Reportable Events, regarding medical devices. "2B. Patient death or serious injury associated with the use or function of a device in patient care, in which the device is used or functions other than as intended."  In response, the NQF performed the following modification in the Serious Event 2B:

"Definition of device added to glossary.  Suggested addition significantly expands the event and will be considered at next update."   View Document

The definition of the term, device, was clarified so endotracheal tubes and NG Tubes will be included.  Thus, insertion of an NG tube into the lungs and feeding the patient and the placement of an endotracheal tube into the esophagus and ventilating the patient are now clearly reportable events.  

2)  Non-Payment & Value Based Purchasing of Hospital Acquired Conditions
  

Health Watch USAsm was one of the main initiators of the national CMS policy of Medicaid adopting Medicare's policy on the non-payment of hospital acquired conditions. 

HW USA was an initiator and facilitator of this initiative on a national level with activities involving conference presentations, forming partnerships with patient advocacy organizations, and advocacy on Capital Hill. This effort started in the Spring of 2008 and was promoted in the 2008 Health Watch USA fall conference.  Ken Conner, JD,  presented on Medicare and Medicaid non-payment of never events.  Lisa McGiffert from Consumer Union also presented and after the conference joined with Health Watch USA and advanced on Capitol Hill the policy of Medicaid Adopting Medicare Regulations regarding Non-payment of Never Events.   

This provision was signed into Federal law in the 2010 Healthcare Reform Bill by President Barack Obama on Tuesday, March 23, 2010. Consumer Union played a major role in advancing and advocating for this legislation.

On July 1, 2010 Kentucky Medicaid adopted regulations for the non-payment of never events and hospital acquired conditions.

   

Non-payment policy of Hospital Acquired Conditions is not Effective in Medicare's DRG Payment System

  • Letter to the editor regarding: The effectiveness of Medicare's non-payment of hospital-acquired conditions policy   Health Policy.  August 27, 2014.  http://www.healthwatchusa.org/HWUSA-Publications/PDF-Downloads/20140829-JHP-HAC-Letter.pdf 

  • Letter to the Editor Regarding "Letter to the Editor Regarding "Nonpayment for Preventable Infections in U.S. Hospitals".    New England Journal of Medicine.  2013;  Jan. 368:191-192.  PMID: 23301747   FREE ACCESS   http://www.nejm.org/doi/full/10.1056/NEJMc1213732  

  • Medicare's Payment Policy for Hospital Acquired Conditions. The Commonwealth Fund July 5, 2011.
    Read Comment

  • New CMS Valuing Based Purchasing Initiative for HACs Proposed by CMS.   Enacted Aug 22, 2014

  • 2014, June26 - Comment on CMS Proposal to Penalize Worst Performing Hospitals in HAC Prevention.
    Read Comment
     

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