Improving value is one of the central aims of recent and ongoing health care reform. In our LDI/INQRI Brief last month, we reviewed the evidence of the role of nurses in increasing the value of health care. In this companion brief, we dig deeper into the three reimbursement strategies that Medicare uses to align hospital financial incentives with quality of care, and we calculate the potential effects of nursing-sensitive quality indicators on hospital payments. Three Medicare programs link hospital quality to payments. The Affordable Care Act (ACA) authorized Medicare to change the way it pays hospitals to reward high-quality, high-value care. Three programs now link Medicare reimbursement to the outcomes and costs of inpatient care: the Value-Based Purchasing (VBP) program, the Hospital-Acquired Conditions (HAC) Reduction Program, and the Hospital Readmissions Reduction Program (HRRP). Each adjusts Medicare payments according to how well hospitals perform on quality measures, and lays the foundation for increased provider accountability and greater value in hospital care.
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