Dive Brief:
- New research by a group at the Harvard School of Public Health has concluded that safety-net and public hospitals are doing the worst under CMS's Hospital Value-Based Purchasing program.
- According to their analysis, hospitals in the highest quartile of the disproportionate share hospital index --- in other words, treating the most low-income patients -- got an adjusted average total payment penalty of 0.09%, and public hospitals saw a 0.1% penalty.
- On the other hand, hospitals in the lowest DSH quartile got an average bonus of 0.06 percent, and nonproofits got an average penalty of 0.03%.
Dive Insight:
As study leader Ashish Jha, MD, points out, it's not clear why public and safety-net hospitals are doing worse than other hospitals in the VBP program. But I think we can hazard a guess.These hospitals, which see a high percentage of chronically-ill uninsured patients, have fewer resources than their peers, making it difficult to meet a set of pre-determined quality standards. Perhaps it'd be better to judge these facilities against one another than forcing them to compete with well-off suburban facilities with a strong commercial payer base. That at least would compare apples to apples.