Contact: Denise Bouillerce
Pleasanton, CA – ValleyCare Medical Center has been designated by CalPERS and Anthem Blue Cross as one of 45 hospitals throughout California where hip and knee replacement surgeries can be performed for their CalPERS members. As part of Value Based Purchasing, it has been designed to keep out-of-pocket costs down as well as limiting the overall increase of medical costs.
The Value Based Purchasing Program is a result of the Deficit Reduction Act of 2005, which authorized the Centers for Medicare and Medicaid Services (CMS) to develop a plan to implement a pay-for-performance or Value-Based Purchasing (VBP) Program for Medicare services provided by hospitals.
Medicare’s Reporting Hospital Quality Data for Annual Payment Update program recommended replacing the current quality reporting program with one that would include public reporting and financial incentives to drive improvements in clinical quality, patient centeredness and efficiency.
Scoring is based upon the data reported by hospitals in three quality domains:
Clinical process of care
Patients’ perspectives of care
The concept of value-based health care purchasing is that buyers should hold providers of health care accountable for both cost and quality of care. Value-based purchasing brings together information on the quality of health care, including patient outcomes and health status, with data on the dollar outlays going towards health. It focuses on managing the use of the health care system to reduce inappropriate care and to identify and reward the best-performing providers.
Members of CalPers and Anthem Blue Cross Preferred Provider Organization (PPO) can choose any facility, but by seeking services from ValleyCare, or one of the designated 45 facilities in California, members can lower their out-of-pocket costs.