Dive Brief:
- CMS has completed its second round of bonuses and penalties to hospitals under the Value-Based Purchasing Program, which raises and lowers reimbursement levels based on 24 quality measures.
- Medicare cut rates for 1,451 hospitals and bumped up rates for 1,231 hospitals, on a scale that also included patient satisfaction measures and death rates.
- Just over two-thirds of high-performing hospitals were also high performers last year; meanwhile, about three-quarters of lower-performing hospitals had incentives adjusted by a factor of less than one, suggesting that they're capable of improvement, CMS said.
Dive Insight:
Paying based on quality is a good idea in theory, but in practice it's a questionable way of getting the real goods. Yes, there's probably a meaningful difference in quality between the worst-performing and highest-performing hospitals in this program, but those in the middle probably do deserve more of a benefit of the doubt. After all, as critics of this program point out, adjusting for patient acuity at tertiary care and inner-city hospitals fairly is tricky, and it's also true that specialty hospitals are able to cherry-pick patients and keep their scores high. Next-generation value purchasing efforts by Medicare will need to make adjustments in what and how how they measure, if value is really what they want.