10.25376/hra.7255973.v1
Matlin Gilman
Matlin
Gilman
E. Kathleen Adams
E. Kathleen
Adams
Jason Hockenberry
Jason
Hockenberry
Arnold Milstein
Arnold
Milstein
Ira B. Wilson
Ira
B. Wilson
Edmund R. Becker
Edmund R.
Becker
Safety-Net Hospitals More Likely Than Other Hospitals To Fare Poorly Under Medicare’s Value-Based Purchasing
Health Research Alliance
2018
United States–Us
Value added
medicare
hospitals
Mortality
performance evaluations
fines & penalties
Social Policy
health care industry
Experimental Treatment
Health Care
Social Policy
Performance Evaluation; Testing and Simulation of Reliability
2018-11-01 13:50:54
Dataset
https://hra.figshare.com/articles/dataset/Safety-Net_Hospitals_More_Likely_Than_Other_Hospitals_To_Fare_Poorly_Under_Medicare_s_Value-Based_Purchasing/7255973
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.