insurance

Health care reform you can expect in 2012

Value-based purchasing
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Value-based purchasing

Effective: Oct. 1, 2012

Another piece of health care reform that starts in 2012 under the law is Medicare's new Value-based Purchasing program, or VBP, which is designed to improve the quality of patient care by linking provider payments to the cost and quality of the care they provide.

It also requires that hospital performance statistics be made publically available for the first time.

"VBP is a broad category that incorporates a lot of things like bundle payments," says Zirkelbach. "For instance, in defined situations like a knee replacement, instead of paying a doctor for every service they provide to replace a knee, they get paid a lump sum to replace somebody's knee. So there's an incentive for them to do it as efficiently as possible while also providing high-quality care, as opposed to a fee-for-service arrangement where there is an incentive to do more tests and procedures because there is more money involved."

Dr. Stream calls VBP the payment paradigm of the future.

"The idea is: Pay better for quality medical groups and doctors who have low infection rates (and) high scores on quality measures for care of diabetes, asthma, heart failure, low hospital readmission rates," he says. "We should be paying for quality -- meaning value -- as opposed to just volume."


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