124 STAT. 356 PUBLIC LAW 111–148—MAR. 23, 2010 total performance of each hospital based on performance standards with respect to the measures selected under paragraph (2) for a performance period (as established under paragraph (4)). Using such methodology, the Sec- retary shall provide for an assessment (in this subsection referred to as the ‘hospital performance score’) for each hospital for each performance period. ‘‘(B) APPLICATION.— ‘‘(i) APPROPRIATE DISTRIBUTION.—The Secretary shall ensure that the application of the methodology developed under subparagraph (A) results in an appro- priate distribution of value-based incentive payments under paragraph (6) among hospitals achieving dif- ferent levels of hospital performance scores, with hos- pitals achieving the highest hospital performance scores receiving the largest value-based incentive pay- ments. ‘‘(ii) HIGHER OF ACHIEVEMENT OR IMPROVEMENT.— The methodology developed under subparagraph (A) shall provide that the hospital performance score is determined using the higher of its achievement or improvement score for each measure. ‘‘(iii) WEIGHTS.—The methodology developed under subparagraph (A) shall provide for the assignment of weights for categories of measures as the Secretary determines appropriate. ‘‘(iv) NO MINIMUM PERFORMANCE STANDARD.—The Secretary shall not set a minimum performance standard in determining the hospital performance score for any hospital. ‘‘(v) REFLECTION OF MEASURES APPLICABLE TO THE HOSPITAL.—The hospital performance score for a hos- pital shall reflect the measures that apply to the hos- pital. ‘‘(6) CALCULATION OF VALUE-BASED INCENTIVE PAYMENTS.— ‘‘(A) IN GENERAL.—In the case of a hospital that the Secretary determines meets (or exceeds) the performance standards under paragraph (3) for the performance period for a fiscal year (as established under paragraph (4)), the Secretary shall increase the base operating DRG payment amount (as defined in paragraph (7)(D)), as determined after application of paragraph (7)(B)(i), for a hospital for each discharge occurring in such fiscal year by the value- based incentive payment amount. ‘‘(B) VALUE-BASED INCENTIVE PAYMENT AMOUNT.—The value-based incentive payment amount for each discharge of a hospital in a fiscal year shall be equal to the product of— ‘‘(i) the base operating DRG payment amount (as defined in paragraph (7)(D)) for the discharge for the hospital for such fiscal year; and ‘‘(ii) the value-based incentive payment percentage specified under subparagraph (C) for the hospital for such fiscal year. ‘‘(C) VALUE-BASED INCENTIVE PAYMENT PERCENTAGE.— Determination.
