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The Centers for Medicare & Medicaid Services (CMS) launched the Value-Based Purchasing (VBP) Program in 2013 to reward hospitals that provided high-quality care.

Under the Value-Based Purchasing Program, hospitals are eligible for an increase or decrease in their Inpatient Prospective Payment System rate, a model that determines Medicare reimbursement for each hospital based on the quality of care provided.

In fiscal year 2019, the payments are supported through a 2 percent reduction of Diagnosis-Related Group fund­ing for all hospitals, which in turn is distributed between eligible facilities according to performance.

The performance measurement domains for the 2019 Hospital Value-Based Purchasing Program are:

  • Clinical Care
  • Safety
  • Person and Community Engagement
  • Efficiency and Cost Reduction

For the year, the total amount of available funds is approximately $1.9 billion.

Overall, about 56 percent of hospitals received positive adjustments in 2019.

Of those receiving bonuses, the average adjustment rate was 0.61 percent, with an average estimated increase in revenue of about $124,354. Hospitals with high positive adjustment rates tended to be smaller, and the majority of facilities earning rates over 1 percent had less than 100 beds.

The highest estimated revenue earners had modest rate increases, though their larger size translated to greater bonus payments overall.

Among penalized hospitals, the average adjustment was -0.39 percent, with an average estimated revenue de­crease of nearly $156,256. Compared to hospitals with positive rate adjustments, the facilities were usually larger, averaging 255 staffed beds versus 173.

Top 20 Hospitals by Value-Based Purchasing

  Hospital Name Definitive ID Estimated 2019 Revenue Adjustment Medicare FY 2019 Adjustment Net Patient Revenue Staffed Beds

1.

Mayo Clinic Hospital - Saint Marys Campus (MN)

2191

$3,578,546

1.08%

$2,584,637,894

1,115

2.

AdventHealth Orlando (FL)

873

$2,589,745

0.75%

$3,769,768,374

2,753

3.

Mayo Clinic Hospital - Arizona (AZ)

178

$1,551,755

1.38%

$1,392,149,121

269

4.

Massachusetts General Hospital (MA)

1973

$1,257,414

0.45%

$2,903,757,623

987

5.

Cleveland Clinic Main Campus (OH)

3120

$1,186,206

0.54%

$5,164,424,360

1,285

6.

St Cloud Hospital (MN)

2223

$1,185,926

0.81%

$852,750,902

451

7.

UAB Hospital (AL)

71

$1,117,317

0.77%

$1,548,385,737

1,063

8.

FirstHealth Moore Regional Hospital (NC)

3011

$1,095,849

1.05%

$627,661,607

412

9.

Piedmont Atlanta Hospital (GA)

998

$1,065,764

0.93%

$946,187,728

488

10.

UCSF Helen Diller Medical Center at Parnassus Heights (CA)

560

$1,041,401

0.54%

$3,620,962,130

782

11.

Cedars-Sinai Medical Center (CA)

430

$1,036,631

0.33%

$3,140,742,831

880

12.

Ascension Providence Hospital - Southfield Campus (MI)

2062

$996,418

0.87%

$572,753,485

582

13.

Munson Medical Center (MI)

2018

$992,667

1.06%

$591,056,215

409

14.

UNC Rex Hospital (NC)

3039

$942,976

0.81%

$1,060,817,400

439

15.

Mercy Hospital (MN)

2119

$910,844

0.82%

$724,833,736

466

16.

Northwestern Memorial Hospital (IL)

1135

$876,244

0.54%

$1,745,967,766

883

17.

Northeast Georgia Medical Center (GA)

1010

$854,047

0.71%

$1,266,568,544

545

18.

Providence St Patrick Hospital (MT)

2475

$853,884

1.64%

$352,654,628

158

19.

Baylor Scott & White Medical Center-Temple (TX)

3849

$808,846

0.58%

$1,335,881,066

640

20.

The University of Kansas Hospital (KS)

1631

$797,571

0.60%

$1,975,125,402

831

Fig 1. Data from Definitive Healthcare, Revenue adjustment is estimated 2019 data; Net patient revenue and staffed beds is 2018 data. Based on most recent CMS data update.