An Example of Translating Value-Based Purchasing Into Value-Based Care.

Abstract

The Affordable Care Act (ACA) (2010) launch of Medicare Value-Based Purchasing (VBP) has become the platform for buyers of health care to hold health care providers accountable for demonstrating high-quality, cost-effective care for Medicare recipients across the trajectory of care practitioners and settings (Gardner, 2013; VanLare & Conway, 2012). The Centers for Medicare and Medicaid Services (CMS), authorized under the ACA, specified quality measures that will best advance the National Quality strategic objectives and build upon the Hospital Inpatient Quality Reporting infrastructure (U.S. Department of Health & Human Services [DHHS], 2013). The quality performance measure domains for fiscal year 2013 focused on Clinical Process of Care and Patient Experience of Care domains. Strategically, quality measures will expand to include delivery of care models, and coordinated care focused on promoting health wellness and health maintenance within the community setting (VanLare & Conway, 2012). Value-based purchasing affords nursing the opportunity to lead the charge in developing innovative delivery of care models to improve the quality of care at a lower cost and shift from providing sick care toward population-focused, preventative, and health promotion care (Gofin, Gofin, & Stimpson, 2014; Marsh, Diers, & Jenkins, 2013).