On October 1, 2015 the Government Accountability Office (GAO) released a report on the Medicare Hospital-value Based Purchasing (HVBP) program. GAO found no apparent shift in existing trends in hospitals’ performance on the quality measures included in the HVBP program during the program’s initial years. However, they believe shifts in quality trends could emerge in the future as the HVBP program continues to evolve. The HVBP program was enacted in 2010 as part of the Patient Protection and Affordable Care Act. The first HVBP payment adjustments occurred in fiscal year 2013. More information on the HVBP program can be found on the CMS website.