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Member Research & Reports

Member Research & Reports

Emory Finds Medicare’s Value-based Purchasing Could Put Safety-net Hospitals at a Financial Disadvantage

Medicare’s value based purchasing (VBP) program puts safety net hospitals at a financial disadvantage compared to other hospitals, according to an analysis conducted by researchers at Emory’s Rollins School of Public Health.

According to the paper, published in the March edition of Health Affairs, the team measured data from Centers for Medicare and Medicaid Services (CMS) to examine whether the inclusion of mortality measure in the second year of the VBP had a disproportionate impact on safety-net hospitals nationally.  Data such as the VBP payment adjustment amount and process, patient experience, and mortality scores of participating hospitals in 2014 along with the Medicare impact file for 2014 that contains hospital payment information, Hospital Compare data for 2014, and other data, such as CMS data, were analyzed.

Findings of the paper indicated that safety-net hospitals were more likely than others to be penalized under the VBP as a result of their poorer performance on process and patient experience scores.

“We see these results largely due to the poor performance on the two elements that currently are assigned the greatest weight in the VBP program which were process of care and patient experiences,” explains Dr. Jason Hockenberry, associate professor in department of health policy and management at Rollins School of Public Health. “We did learn that the inclusion of mortality scores in CMS’s VBP program did not further impact safety-net hospitals. Their performance was similar to other hospitals on this measure.”

Researchers also suggest that more research is needed into the comprehensive impact of the various performance-based payment adjustments on hospitals’ financial well being.

“These hospitals are an important resource to the communities they serve, and maintaining financial health is key to their ability to serve these communities,” he says.

Complete findings are available at: