Value-based purchasing and the doctor-patient relationship.

The Value-Based Purchasing (VBP) program was established by the Secretary of Health and Human Services, in accordance with mandates under the Patient Protection and Affordable Care Act of 2010. Under the VBP program, the Centers for Medicare & Medicaid Services will decrease payments for certain Diagnosis Related Group (DRG) payments. Of the approximately 3100 acute care hospitals affected by the reductions, which hospitals will be able to recoup some of the losses and which ones will be forfeiting the total amount will be decided by predetermined performance measures. Seventy percent of the VBP Total Performance Score (TPS) will involve the Process of Core Measures, which include quality measures of treatment of acute myocardial infarction, heart failure, pneumonia, healthcare-associated infections, and surgical care improvement. The remaining 30% of the TPS will be determined by patient satisfaction. Hospitals will be graded according to points awarded for quality achievement, improvement from baseline, and consistency.