GAO: Value-based purchasing having little impact at 3-year mark
- The Hospital Value-Based Purchasing Program, an ACA initiative aimed at improving quality of care through hospital payments and penalties based on performance, has yet to demonstrate improvements in care, according to a new Government Accountability Office (GAO) report.
- The audit concludes the effect has been minimal, with the majority of hospitals seeing their Medicare payment rates change up or down by less than half a percentage point.
- As of Sept. 30, the end of the fiscal year, 74% of hospitals were inside that range, receiving a median bonus of $39,000 and a median penalty of $56,000.
While CMS did not comment on the report, it has previously stated it is looking toward the future and expecting long-term effects.
The GAO analysts took a similar view. "[The] analysis 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," the report stated. "However, shifts in quality trends could emerge in the future as the HVBP program continues to evolve.
The report adds safety-net hospitals have fared the worst in the program while the most financially sound hospitals have performed the best. Hospitals with a net income above 5% received bonuses averaging 0.23% in 2015.
However, the report also points toward the decrease in hospital readmission rates following the implementation of an incentive program as an indication financial incentives "may, under certain circumstances, promote enhanced quality of care."