By: Sharath Joji  May. 11, 2021

Allegheny General Hospital in Pittsburgh, PA, reported a CMS Value Based Purchasing (VBP) Adjustment Factor of 0.9917 in the year 2021, which could result in an estimated penalty of $528,208. Medicare Spending Per Beneficiary (MSPB) accounts for 25% of overall VBP score and is a significant factor in driving VBP payments. MSPB costs include the costs from 3 days before hospitalization, index hospital stays, and 30 days post-discharge. The measure score of the Efficiency & Cost Reduction domain for Allegheny General Hospital during the period was 0/10. Dexur is an approved purchaser of CMS Medicare claims data and based on our simulator, we estimate that Allegheny General Hospital can avoid VBP penalties by reducing MSPB Costs by 12.5%.