PROJECT SUMMARY/ABSTRACT The United States spends more than any country on health care and costs are rising at an unsustainable rate. This is an issue for patient, providers, and payers, including the Centers for Medicare and Medicaid Services (CMS) which provides care for 90 million Americans at a cost of over $600 billion annually. To address escalating costs, the CMS has implemented seven value-based payment programs which reward providers who deliver high-quality care and penalize those that do not. This includes the CMS’ Hospital Value-Based Purchasing (VBP) Program, which in 2019 reallocated nearly 1.9 billion to hospitals based on their performance on four domains: (1) outcomes (i.e. clinical care); (2) patient experience (i.e. person and community engagement); (3) safety; and (4) efficiency and cost reduction. However, one issue with the CMS’ Hospital VBP Program is that it was not developed with patients, and consequently, it is provider-centered rather than patient-centered. For example, within the CMS’ Hospital VBP Program, each of the four domains used to evaluate performance are weighted equally (25% each). This means that a hospitals performance on outcomes is considered equally important as its’ performance on patient experience or safety. This reflects the perspective of the CMS; however, evidence has shown that patients may have very different views than providers or payers on what constitutes value. By failing to consider the perspective of patients, the CMS’ Hospital VBP Program may be rewarding hospitals that are providing care that is not valued by patients and penalizing those that do. The objective of this proposal is to determine how considering the patient perspective in the design of the CMS’ Hospital VBP Program would impact on financial incentive payments to providers. This proposal seeks to (Aim 1) estimate patient-centric ‘value weights’ for the four domains in the CMS’ Hospital VBP Program. The weights will be estimated by administering a survey containing a discrete choice experiment in a nationally representative sample of Medicare patients. The results will then be used to (Aim 2) estimate the impact of using patient-centric weights on hospital reimbursement in fiscal year 2019. This will be accomplished by using publically available data on the performance of 2,786 hospitals enrolled in the CMS’ Hospital VBP Program.