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4.12: Value-Based Care and Pay for Performance

DOI:

10.1891/9780826148476.0042

Abstract

Beginning with the Affordable Care Act (ACA), there has been a more significant focus on quality than ever before. The Centers for Medicare & Medicaid Services (CMS) have been at the heart of this quality effort and has done many different things to drive quality in the facility. The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program is one of these things. This program rewards high-performing facilities with an incentive payment based on the quality of care which they provide. This quality is ultimately based upon specific measures surrounding hospital readmissions. The SNF VBP is a part of the Social Security Act, which was added to by the Protecting Access to Medicare Act of 2014 (PAMA). Under the SNF VBP, SNFs can expect the following: evaluations for performance on specific hospital readmission measures; scoring for both improvement and achievement; feedback via quarterly reports concerning performance; incentive payments based on performance.