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

: Under the Hospital Value Based Purchasing (HVBP) program, an adjustment is made to the base operating DRG amount for certain Inpatient Prospective Payment System (IPPS) hospitals - based on their Total Performance Score (TPS).

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) IPPS hospitals. There is a variable that indicates whether the hospital was excluded from HVBP (see CLM_VBP_PRTCPNT_IND_CD). This percentage reduction is applied to the base operating DRG amount, depending on their TPS (which is the Value Based Purchasing Score), as required by the Affordable Care Act (ACA). The percentages change each FY.

Additional information is available on the CMS "Hospital Value-Based Purchasing" website.

The actual dollar amount of the adjustment that applied to the claim is found in the variable called CLM_VBP_ADJSTMT_PMT_AMT.