The economic crisis in America, over the last few years, has affected everyone, especially healthcare facilities. Healthcare cost has increased more than the rate of inflation for many years. Medicare is trying to find ways to reduce costs. One of these ways is called Value-based purchasing (VBP). This program was authorized by the Patient Protection and Accountable Care Act of 2010, and gives the Centers for Medicare & Medicaid Services (CMS) (this is the part of Medicare that sets the reimbursement rates for Medicare) the power to base a portion of hospital reimbursement payments on how well hospitals perform on treating patients and on patient satisfaction scores. You must write about the individual measures for Acute Myocardial Infarction . List and analyze the individual measures of Acute Mycocardial Infarction. The individual measures are listed below. Give your opinion of VBP and whether you feel it is fair and what improvements you would recommend. The individual measures for each are:

Heart Attack (Acute Myocardial Infarction) (Core measure)

Individual measures

• Aspirin at Arrival
• Aspirin Prescribed at Discharge
• ACEI or ARB for LVSD
• Beta-Blocker Prescribed at Discharge
• Median Time to Fibrinolysis
• Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival
• Median Time to Primary PCI
• Primary PCI Received Within 90 Minutes of Hospital Arrival
• Statin Prescribed at Discharge