FY 2019 HVBP Results Released: Most Hospitals Will See Modest Adjustments to their IPPS Payments

On December 3, 2018, the Centers for Medicare and Medicaid Services (CMS) released fiscal year (FY) 2019 results from the Hospital Value Based Purchasing Program (HVBP). Under the HVBP CMS adjusts hospital payment for Inpatient Prospective Payment System (IPPS) services based on the quality of inpatient care the hospitals provide to patients. A two percent withhold from base operating Diagnosis-Related Group (DRG) payment amounts is redistributed to participating hospitals based on their performance on a set of quality and cost measures. CMS estimates that the total amount available for value-based incentive payments in FY 2019 will be approximately $1.9 billion.

Approximately 2,800 hospitals across the country participate in the program. For FY 2019, more hospitals will have an increase in their Medicare payments than a decrease. In total, more than 1,550 hospitals (over 55 percent) will receive higher Medicare payments.

While payment adjustments range from -1.59 percent to a positive adjustment of 3.69 percent, almost 60 percent of hospitals will see a small change (between -0.5 and 0.5 percent) in their IPPS payments. The average net payment adjustment is 0.17 percent. The average net increase in payment adjustments is 0.61 percent, and the average net decrease in payment adjustments is -0.39 percent.

A fact sheet on the FY 2019 HVBP results is available here.

For more information on the Hospital VBP Program, please visit the CMS website or the QualityNet website.


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or smadhani@mcdermottplus.com or Mara McDermott at 202-204-1462 or mmcdermott@mcdermottplus.com.