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 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%

FY 2019 Scoring

Domain Weight
Clinical Care 25%
Person and Community Engagement 25%
Safety 25%
Efficiency and Cost Reduction 25%

Weighting for FY 2018 and FY 2019

For FY 2018 and FY 2019, 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 Caregiver-Centered Experience of Care/Care Coordination (FY 2018)/Person and Community Engagement (FY 2019) domain, the weighting will be reallocated to the remaining applicable domains.

As noted above, the FY 2018 and FY 2019 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.

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