Value-based purchasing legislation for post-acute care is too focused on cutting payments, and not enough on promoting high quality, lower cost care, the American Hospital Association said this week.

In a letter to the House Ways and Means Committee, the AHA called the the Medicare Post-Acute Care Value Based Purchasing Act of 2015 “too narrowly focused” on the cost component of value. A successful VBP program should include equal measures for both cost and quality, and be more “budget neutral,” AHA wrote. Currently only 50% to 70% of withheld funds would be returned to providers, with the rest kept as Medicare savings.

“Without a more balanced, budget neutral approach that includes an assessment of quality, the PAC VBP program appears to function as a mechanism to cut provider payments in perpetuity, rather than primarily as a way to promote value,” wrote Thomas P. Nickels, Executive Vice President of AHA, in the letter.