# Scoring

## Hospital Value-Based Purchasing (HVBP)

A hospital’s performance in Hospital Value-Based Purchasing (HVBP) is based on measures/dimensions for the domains per fiscal year (FY). The hospital’s Total Performance Score (TPS) is composed of the following:

## FY 2016 Scoring

Domain | Weight |
---|---|

Clinical Process of Care | 10% |

Patient Experience of Care | 25% |

Outcome | 40% |

Efficiency | 25% |

## Weighting for FY 2016

For FY 2016, the TPS will be re-weighted proportionately to the scored domains for hospitals with at least two (2) out of four (4) domain scores. The TPS will be scored out of a possible 100 points, and the relative weights for the scored domains will remain equivalent.

For example, when a hospital meets the minimum case and measure requirements for the Clinical Process of Care, Patient Experience of Care and Outcome domains but does **not** meet the minimum case requirements for the Efficiency domain, the weighting will be reallocated to the remaining applicable domains.

As noted above, the weight of the Efficiency domain is 25 percent; therefore, the total weight between the remaining applicable domains—Clinical Process of Care (10 percent), Patient Experience of Care (25 percent) and Outcome (40 percent)—is 75 percent.

In this example, the reallocated weighting for the remaining applicable domains is:

- Clinical Process of Care = 13.3%
- Patient Experience of Care = 33.3%
- Outcome = 53.3%

**Note**: Calculated reallocated weighting has been rounded. A greater precision of the calculated value will be used on the Percentage Payment Summary Reports.

The formula to calculate the re-weighting of the measures is as follows:

Original weight of each remaining domain ÷ total weight of remaining domains x 100

The reallocated weights must total 100 percent.

Refer to the Hospital VBP FY 2016 Baseline Report Overview handout (PDF-2.2 MB) from the April 29, 2014, National Provider Call for details regarding measure re-weighting.

## FY 2017 Scoring

Domain | Weight |
---|---|

Clinical Care – Process | 5% |

Clinical Care – Outcomes | 25% |

Patient- and Caregiver-Centered Experience of Care/Care Coordination | 25% |

Safety | 20% |

Efficiency and Cost Reduction | 25% |

## Weighting for FY 2017

For FY 2017, the TPS will be re-weighted proportionately to the scored domains for hospitals with at least three (3) out of four (4) domain scores. The TPS will be scored out of a possible 100 points, and the relative weights for the scored domains will remain equivalent.

For example, when a hospital meets the minimum case and measure requirements for the Clinical Care -Process subdomain, Safety domain and Efficiency and Cost Reduction domain but does **not** meet the minimum case requirements for the Clinical Care – Outcomes subdomain and the Patient- and Caregiver-Centered Experience of Care/Care Coordination domain, the weighting will be reallocated to the remaining applicable domains.

As noted above, the weight of the Patient- and Caregiver-Centered Experience of Care/Care Coordination domain is 25 percent and the Clinical Care – Outcomes subdomain is 25%; therefore, the total weight between the remaining applicable domains—Clinical Care – Process subdomain (5 percent), Safety domain (20 percent) and Efficiency and Cost Reduction domain (25 percent)—is 50 percent.

In this example, the reallocated weighting for the remaining applicable domains is:

- Clinical Care - Process = 10%
- Safety = 40%
- Efficiency and Cost Reduction = 50%

The formula to calculate the re-weighting of the measures is as follows:

Original weight of each remaining domain ÷ total weight of remaining domains x 100

The reallocated weights must total 100 percent.

**Note**: A hospital meeting the minimum cases in both or either of the Clinical Care subdomains will be treated as meeting the minimum measures for the count of one domain (Clinical Care).

See the Overview of the Hospital Value-Based Purchasing (VBP) Fiscal Year (FY) 2017 handout (PDF-1.5 MB) from the February 17, 2015, National Provider Call for details regarding measure re-weighting.

## FY 2018 Scoring

Domain | Weight |
---|---|

Clinical Care | 25% |

Patient- and Caregiver-Centered Experience of Care/Care Coordination | 25% |

Safety | 25% |

Efficiency and Cost Reduction | 25% |

## Weighting for FY 2018

For FY 2018, the TPS will be re-weighted proportionately to the scored domains for hospitals with at least three (3) out of four (4) domain scores. The TPS will be scored out of a possible 100 points, and the relative weights for the scored domains will remain equivalent.

For example, when a hospital meets the minimum case and measure requirements for the Clinical Care domain, Safety domain and Efficiency domain but does **not** meet the minimum case requirements for the Patient- and Patient- and Caregiver-Centered Experience of Care/Care Coordination domain, the weighting will be reallocated to the remaining applicable domains.

As noted above, the FY18 scoring is based on each of the four domains weighted equally at 25 percent each. Therefore, in the previous example the reallocation of weighting would be as follows:

- Clinical Care = 33.3%
- Safety = 33.3%
- Efficiency and Cost Reduction = 33.3%

The formula to calculate the re-weighting of the measures is as follows:

Original weight of each remaining domain ÷ total weight of remaining domains x 100

The reallocated weights must total 100 percent.