On August 17, 2009, CMS announced three new Medicare value-based purchasing demonstrations. The Nursing Home Value-Based Purchasing Demonstration will reward facilities that can improve or deliver high quality care in four specific areas: staffing, resident outcomes, avoidable hospitalizations, and reductions in deficiency citations. It will involve nearly 200 nursing homes in three states, and will run from July 2009 through June 2012. The Medicare Hospital Gainsharing Demonstration and the Physician Hospital Collaboration Demonstration are evaluating mechanisms for hospitals and physicians to join forces to improve quality and efficiency of care, establish effective means to govern use of inpatient resources, reduce costs, and share the rewards. The agency also provided an update on three ongoing VBP demonstrations: the Hospital Quality Incentive Demonstration, the Physician Group Practice Demonstration, and the Medicare Care Management Performance Demonstration.