Focus on overall quality to succeed under value-based purchasing.

The move toward value-based purchasing by the Centers for Medicare & Medicaid Services means that hospitals need to focus on overall quality improvement rather than limiting their efforts to just a few conditions. To keep the initiative budget neutral, CMS is reducing the base operating DRG payment for all Medicare fee-for-service discharges, but hospitals can earn bonuses by performing well. CMS intends to add more measures in the future and can include any measures already being tracked in the Inpatient Quality Reporting Program. Medicare spending per beneficiary will be part of value-based purchasing in fiscal 2015 and will hold hospitals accountable for costs incurred by patients beginning three days before admission to 30 days after discharge.