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CMS' Value-Based Programs


What are the value-based programs?

Value-based programs reward health care providers with incentive payments for the quality of care they give to people with Medicare. These programs are part of our larger quality strategy to reform how health care is delivered and paid for. Value-based programs also support our three-part aim:

  • Better care for individuals
  • Better health for populations
  • Lower cost

Why are value-based programs important?

Our value-based programs are important because they’re helping us move toward paying providers based on the quality, rather than the quantity of care they give patients.  

What are CMS’ original value-based programs?

There are four original value-based programs; their goal is to link provider performance of quality measures to provider payment:

  • Hospital Value-Based Purchasing (HVBP) Program
  • Hospital Readmission Reduction (HRR) Program
  • Value Modifier (VM) Program (also called the Physician Value-Based Modifier or PVBM)
  • Hospital Acquired Conditions (HAC) Program

Are there other value-based programs?

There are several other value-based programs:

  • End-Stage Renal Disease (ESRD) Quality Initiative Program
  • Skilled Nursing Facility Value-Based Program (SNFVBP)
  • Home Health Value Based Program (HHVBP)

 

What's the timeline for these programs?

 

How do value-based programs work with other CMS quality efforts?