Hospital Value Model (HVM) Support

This page contains educational resources to help ensure your success as a participating hospital with Blue Shield's Hospital Value Model.

The Hospital Value Model (HVM) overview

The HVM offers network hospitals the opportunity to earn an annual incentive payment (based on the prior year’s hospital spend for eligible members) tied to quality outcomes on key hospital performance indicators. There is no supplemental data required to participate.

Hospitals participating in the HVM will receive an annual scorecard on performance related to safety, utilization, and patient experience. It is an upside-only model that does not require any additional supplemental data reporting by participating hospitals. The HVM will be applied to services delivered to the fully insured PPO and/or HMO populations. Long-term care, critical access, children’s, psychiatric, rehabilitation, and prospective payment system-exempt cancer hospitals will be excluded from participating in the HVM.

Attainment-improvement model methodology

Using attainment and improvement methodology, a total score on key metrics will be used to determine whether a hospital is eligible for an incentive payment. The higher of either the attainment or improvement score will be used in calculating the incentive payment. This upside-only model rewards hospitals at all levels on the quality spectrum by calculating scoring based on a sliding scale at the individual measure level.

HVM training webinar

The HVM training webinar provides a detailed overview of the model.

HVM Frequently Asked Questions (FAQs)

The FAQs (PDF, 154 KB) provides answers to common questions about the Hospital Value Model (HVM).

HVM operational guidelines

The HVM operational guidelines (PDF, 373 KB) provides more detail on the model methodology, eligibility, performance metrics, and operations using easy-to-understand graphics and examples. Review this document in its entirety or use the clickable table of contents to navigate to the content you need.