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Safety-net hospitals more likely than other hospitals to fare poorly under Medicare's value-based purchasing

Health Affairs, 2015-03, Vol.34 (3), p.398-405 [Peer Reviewed Journal]

Project HOPE—The People-to-People Health Foundation, Inc. ;Copyright The People to People Health Foundation, Inc., Project HOPE Mar 2015 ;ISSN: 0278-2715 ;EISSN: 1544-5208 ;EISSN: 2694-233X ;DOI: 10.1377/hlthaff.2014.1059 ;PMID: 25732489

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Title:
Safety-net hospitals more likely than other hospitals to fare poorly under Medicare's value-based purchasing
Author: Gilman, Matlin ; Adams, E Kathleen ; Hockenberry, Jason M ; Milstein, Arnold S ; Wilson, Ira B ; Becker, Edmund R
Subjects: Chi-Square Distribution ; Databases, Factual ; Fares ; Financial Management, Hospital - organization & administration ; Fines & penalties ; Health care policy ; Health insurance ; Heart attacks ; Heart failure ; Heart Failure - mortality ; Hospital Mortality - trends ; Hospitals ; Hospitals - classification ; Hospitals - statistics & numerical data ; Humans ; Indigent care ; Insurance coverage ; Low income groups ; Medicaid ; Medicare ; Medicare - economics ; Mortality ; Myocardial Infarction - mortality ; Patients ; Payment ; Pneumonia ; Pneumonia - mortality ; Purchasing ; Quality Assurance, Health Care - economics ; Retrospective Studies ; Risk Assessment ; Safety-net Providers - economics ; Safety-net Providers - organization & administration ; Statistical data ; Studies ; United States ; Value added ; Value-Based Purchasing - economics ; Value-Based Purchasing - organization & administration
Is Part Of: Health Affairs, 2015-03, Vol.34 (3), p.398-405
Description: Medicare's value-based purchasing (VBP) program potentially puts safety-net hospitals at a financial disadvantage compared to other hospitals. In 2014, the second year of the program, patient mortality measures were added to the VBP program's algorithm for assigning penalties and rewards. We examined whether the inclusion of mortality measures in the second year of the program had a disproportionate impact on safety-net hospitals nationally. We found that safety-net hospitals were more likely than other hospitals to be penalized under the VBP program as a result of their poorer performance on process and patient experience scores. In 2014, 63 percent of safety-net hospitals versus 51 percent of all other sample hospitals received payment rate reductions under the program. However, safety-net hospitals' performance on mortality measures was comparable to that of other hospitals, with an average VBP survival score of thirty-two versus thirty-one among other hospitals. Although safety-net hospitals are still more likely than other hospitals to fare poorly under the VBP program, increasing the weight given to mortality in the VBP payment algorithm would reduce this disadvantage.
Publisher: United States: The People to People Health Foundation, Inc., Project HOPE
Language: English
Identifier: ISSN: 0278-2715
EISSN: 1544-5208
EISSN: 2694-233X
DOI: 10.1377/hlthaff.2014.1059
PMID: 25732489
Source: MEDLINE
ProQuest Central

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Safety-net hospitals more likely than other hospitals to fare poorly under Medicare's value-based purchasing

Project HOPE—The People-to-People Health Foundation, Inc. ;Copyright The People to People Health Foundation, Inc., Project HOPE Mar 2015 ;ISSN: 0278-2715 ;EISSN: 1544-5208 ;EISSN: 2694-233X ;DOI: 10.1377/hlthaff.2014.1059 ;PMID: 25732489

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