Proposed 2017 Rule Updates Value Based Purchasing Model

The pilot program for Value Based Purchasing (VBP) is going to receive some important updates in the proposed 2017 rule.  The pilot will affect 9 states: Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North Carolina, Tennessee, and Washington.

 

Changes to the VBP Model include:

  1. Selecting 8 agencies as the group to compare data against.
  2. Undeveloped metrics for 4 measures that CMS wasn’t sure how to calculate
    1. Care Management
    2. Prior Function
    3. Flu Vaccine Data
    4. Reasons for not receiving a flu shot.
  3. Adjusted reporting periods – to be determined what the adjustments actually mean.
  4. Additional time to submit data.
  5. Public reporting on how well the model is actually working.
  6. Appeal process is formalized for agencies that feel their data isn’t being treated accurately or fairly.

 

Since this is still just the proposed rule, we aren’t sure if all of these items will make it into the final rule.  Sometimes, CMS can lift your hopes only to burst your bubble in November.  We will keep you posted.  Whichever way the rule for the pilot changes, agencies will need to be ready for January 1, 2017.