The Centers for Medicare and Medicaid Services initiated the hospital value-based purchasing (HVBP) program in an effort to unite reimbursement with quality and patient safety.1  The overall goal of the program is to improve the value of health care provided in inpatient hospital settings. Under the HVBP program, hospitals are financially incentivized for how well they perform on a variety of quality and safety measures or how much they improve in performance. The program, which was implemented less than 5 years ago, has undergone a number of revisions and refinements since its introduction. Given the newness of the program and the ongoing program modifications, the HVBP program is generally not well understood by many health care professionals. Part 1 of this article, which was previously published,2  provided an overview of the basic components of the HVBP program, including program eligibility, domains and performance measures, scoring, and performance periods....

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