Secure Portal enrollment reminder

Registered QualityNet users from participating Hospital IQR and OQR Program facilities are urged to complete Secure Portal enrollment by May 1 to ensure Portal access on July 1.

Eligibility

Hospital Value-Based Purchasing

Minimum Cases and Measures

As required by the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) conducted an independent analysis and established minimum numbers of cases, measures, and surveys for hospitals to be eligible to participate in HVBP. Including hospitals that do not meet the minimum criteria could adversely skew results that would affect the overall program scoring.

CMS has established the following minimum reporting requirements for number of cases, measures, and surveys:

Fiscal Year (FY) 2015 Minimum Reporting Requirements

  • Clinical Process of Care: 10 cases and 4 measures
  • Patient Experience of Care: 100 completed surveys
  • Outcome Measures: Hospitals must report the applicable case minimum for at least 2 of the 5 measures for the Outcome domain.
    • AMI 30-Day Mortality: 25 cases
    • HF 30-Day Mortality: 25 cases
    • PN 30-Day Mortality: 25 cases
    • AHRQ (PSI-90): 3 cases for any one of the underlying indicators
    • HAI (CLABSI): 1 predicted infection
  • Efficiency (Medicare Spending Per Beneficiary): 25 episodes of care

FY 2016 Minimum Reporting Requirements

  • Clinical Process of Care: 10 cases and 4 measures
  • Patient Experience of Care: 100 completed surveys
  • Outcome: Hospitals must report the applicable case minimum for at least 2 of the 7 measures for the Outcome domain.
    • AMI 30-Day Mortality: 25 cases
    • HF 30-Day Mortality: 25 cases
    • PN 30-Day Mortality: 25 cases
    • AHRQ (PSI-90): 3 cases for any one of the underlying indicators
    • CAUTI: 1 predicted infection
    • CLABSI: 1 predicted infection
    • SSI – Colon: 1 predicted infection
    • SSI – Abdominal Hysterectomy: 1 predicted infection
  • Efficiency (Medicare Spending Per Beneficiary): 25 episodes of care

Note: Hospitals with sufficient data in at least 2 of the 4 domains will receive a Total Performance Score (TPS). Refer to Scoring for more information.

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