CMS recently finalized proposals for the Hospital Inpatient Prospective Payment Systems (IPPS), which can be viewed here, including updates for the Value Based Purchasing (VBP) program:
FFY2026 (CY2024 HCAHPS discharges)
- Starting with FFY 2026, the VBP program will return to the standard cycle for the baseline and performance periods post-pandemic. For FFY 2026, the baseline period will use CY 2022 for the performance period of data of CY 2024 for HCAHPS, Safety, and Efficiency.
- The Safety Domain will gain a measure. The Severe Sepsis and Septic Shock: Management Bundle measure will be scored in the Safety Domain beginning with FFY 2026.
- A health equity scoring change for treating a high proportion of underserved patients defined by dual eligibility, rewarding excellent care in underserved populations beginning with the FFY 2026 program year.
- The Total Performance Score (TPS) is now out of a possible 110 points instead of 100
- The additional 10 points are determined by a Health Equity Adjustment Bonus Point calculation that incorporates an “underserved multiplier” to recognize hospitals that score highly despite serving a high proportion of patients who are underserved.
- For additional information please see the recent press release from CMS.
FFY2028 (CY2026 HCAHPS discharges)
- The Efficiency measure, Medicare Spending Per Beneficiary (MSPB) Hospital will be updated to account for readmissions and change the calculation of the measure.
FFY2030 (CY2028 HCAHPS discharges)
- An Outcomes measure, Hospital-level Risk-Standardized Complication Rate (RSCR) Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA), will be updated to include admission diagnoses and in-hospital comorbidity data from Medicare Part A claims.
If you have more questions about this final rule, please reach out to our CAHPS® team at [email protected]