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This variable is contained in the following files: Inpatient (Fee-for-Service)
Short SAS Name
CLM_VBP_ADJSTMT_PMT_AMT
SAS Name
CLM_VBP_ADJSTMT_PMT_AMT

This field represents the Hospital Value Based Purchasing (HVBP) Amount.

This could be an additional payment on the claim or a reduction, depending on the hospital's performance score.

Comments

This initiative began in 4th Quarter of 2013 (i.e., beginning of Federal fiscal year 14 [FY14]). This field was new in 2013, and is null/missing for all previous years.

The HVBP applies only to subsection (d) Inpatient Prospective Payment System (IPPS) hospitals. There is a variable that indicates whether the hospital was excluded from HVBP (see CLM_VBP_PRTCPNT_IND_CD).

This amount is based on a VBP adjustment percent (variable called CLM_VBP_ADJSTMT_PCT) that is applied to the base operating DRG amount, depending on the hospital's Total Performance Score (TPS), which is the Value Based Purchasing Score.

HVBP is required by the Affordable Care Act (ACA). The percentages change each FY. Additional information is available on the CMS "Hospital Value-Based Purchasing" website.

Source: NCH