Value-Based Purchasing (VBP) is a CMS program which aims to improve the quality of care through financial rewards and penalties. The quality of care provided by a hospital, rather than the quantity of services provided, determine the incentive payments.

Performance in four quality measurement domains, as compared to their peers, dictate a hospital’s score:

  • Clinical Care (25%)
  • Safety (25%)
  • Person and Community Engagement (25%)
  • Efficiency and Cost Reduction (25%)

Hospitals with a final score that ranks above the national median receive a percentage bonus to their Medicare reimbursements in the following fiscal year. The incentive payments to hospitals are paid for by penalizing hospitals with scores below the median. So far in 2019, 21 states scored higher than the national average of 39.5.

Nationwide, Average VBP scores ranged from a low of 32.4 to a high of 51.3. North Dakota had the lowest median score at 32.4, and Minnesota had the highest score with 51.3 out of 100. Utah scored closest to the overall average, with a score of 39.4. Case mix index (CMI) does not appear to strongly influence VBP performance, with all states reporting between a 1.0 and 1.5 CMI.

The top 5 states with the highest VBP scores—Minnesota, Oregon, Alaska, Wyoming, and Montana—reported average CMIs between 1.1 and 1.4.

Average State Value-Based Purchasing Score & Selected Metrics by Score

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RankStatePerformance ScoreNet Patient Revenue (M)Case Mix IndexStaffed BedsDischargesExplore This Dataset
1.MN51.38$290,394,0001.28168.807,119Explore This Profile
2.OR50.80$334,179,7081.45201.548,963Explore This Profile
3.AK49.76$161,567,9831.2683.183,164Explore This Profile
4.WY49.42$73,513,3921.2761.241,848Explore This Profile
5.MT47.51$92,696,6181.1365.862,157Explore This Profile
6.WI44.95$250,464,9441.38150.926,235Explore This Profile
7.HI44.94$231,748,1841.36153.306,878Explore This Profile
8.ME44.00$254,612,9601.28137.575,652Explore This Profile
9.SD43.85$175,450,3981.18115.993,820Explore This Profile
10.VT43.11$274,018,7521.22115.005,691Explore This Profile
11.IA43.01$145,526,5361.20122.555,003Explore This Profile
12.MI42.18$420,740,5751.42292.2014,627Explore This Profile
13.OK42.09$122,714,8921.36124.304,658Explore This Profile
14.NM41.42$172,182,5201.30133.935,145Explore This Profile
15.KS41.10$94,324,2151.2486.563,243Explore This Profile
16.CO40.96$290,691,3201.44171.567,709Explore This Profile
17.VA40.84$307,359,2571.43269.6210,705Explore This Profile
18.WV40.35$177,235,806.901.27158.505,935Explore This Profile
19.NC40.21$426,390,3811.43285.2113,823Explore This Profile
20.MO40.17$424,171,223.731.34346.0315,074Explore This Profile
21.UT39.44$262,985,8481.48145.647,275Explore This Profile
22.SC39.12$321,134,8961.42243.1011,312Explore This Profile
23.DE39.05$436,854,5201.47234.3712,680Explore This Profile
24.ID39.03$167,920,5351.3894.744,263Explore This Profile
25.AZ38.94$264,669,7001.46197.809,451Explore This Profile
26LA38.83$111,199,676 1.32125.744,280Explore This Profile
27.WA38.63$486,286,406 1.44264.4513,741Explore This Profile
28.OH38.56$361,895,541 1.43236.0611,089Explore This Profile
29.IL37.87$495,210,688 1.37367.3215,932Explore This Profile
30.IN37.86$238,330,441 1.40172.257,204Explore This Profile
31.GA37.48$256,916,622 1.37211.579,387Explore This Profile
32.CA37.38$499,595,343 1.54320.7315,313Explore This Profile
33.MA37.02$509,076,945 1.34282.3912,826Explore This Profile
34.CT36.89$546,164,983 1.39296.5714,726Explore This Profile
35.KY36.69$212,393,380 1.30232.718,189Explore This Profile
36.NE36.54$105,942,444 1.2794.223,374Explore This Profile
37.NY36.41$609,451,711 1.40359.3817,206Explore This Profile
38.PA36.13$420,450,974 1.42363.1014,605Explore This Profile
39.AL35.81$175,986,121 1.31240.869,274Explore This Profile
40.MS35.26$99,807,855 1.20148.374,149Explore This Profile
41.RI35.12$421,065,967 1.33359.9012,364Explore This Profile
42.NH34.81$233,511,108.201.35118.385,371Explore This Profile
43.TX34.62$236,996,763 1.39228.689,731Explore This Profile
44.TN34.56$632,160,067 1.38608.6928,471Explore This Profile
45.NJ33.47$392,876,973 1.48337.2714,403Explore This Profile
46.FL33.21$347,829,267 1.44312.8616,093Explore This Profile
47.AR32.97$106,283,066 1.30129.035,117Explore This Profile
48.NV32.88$211,823,248 1.34177.329,811Explore This Profile
49.ND32.44$110,308,291 1.0785.192,996Explore This Profile
50.MDN/A$533,847,684 1.44323.1317,110Explore This Profile
Average39.57$290,579,2151.35211.119,304Explore This Profile

Fig 1 Data from Definitive Healthcare based on CMS Quality Metrics Update as of April 2019.