What question did this study set out to answer?

To determine whether patient- and community-level health equity risk factors outside hospital control influence penalty assignments across Centers for Medicare and Medicaid Services (CMS) value-based programs.

July 1, 2023Health Affairs

CMS Hospital Value-Based Programs: Refinements Are Needed To Reduce Health Disparities And Improve Outcomes

View Full Paper

Ask AI

Bookmark

To determine whether patient- and community-level health equity risk factors outside hospital control influence penalty assignments across Centers for Medicare and Medicaid Services (CMS) value-based programs.
Analyzed penalty determinations across three CMS quality initiatives: the Hospital Readmissions Reduction Program, Hospital Value-Based Purchasing Program, and Hospital-Acquired Condition Reduction Program.
Assessed the association between financial penalties and community risk factors, including medical complexity via Hierarchical Condition Categories (HCC) scores, uncompensated care levels, and local proportions of individuals living alone.
Statistically significant positive associations were observed between hospital penalties and uncontrollable community risk factors, specifically higher patient HCC scores, greater uncompensated care, and higher proportions of residents living alone.
Adverse community and environmental risk factors were disproportionately concentrated among hospitals serving historically underserved populations, indicating current CMS risk-adjustment methods do not adequately account for community-level health equity.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Observational analysis reveals disproportionate Medicare payment penalties among hospitals serving medically complex and socially disadvantaged communities, suggesting CMS programs exacerbate...

Cite This Study

Kahn et al. (2023) studied this question.

synapsesocial.com/papers/6a03e4d84a5db22ff2893af9 https://doi.org/10.1377/hlthaff.2022.00844

View Full Paper

Ask AI

Bookmark

Implication

Observational analysis reveals disproportionate Medicare payment penalties among hospitals serving medically complex and socially disadvantaged communities, suggesting CMS programs exacerbate...

CMS Hospital Value-Based Programs: Refinements Are Needed To Reduce Health Disparities And Improve Outcomes

Key Points

Discussion

Implication

Cite This Study

CMS Hospital Value-Based Programs: Refinements Are Needed To Reduce Health Disparities And Improve Outcomes

Key Points

Discussion

Implication

Cite This Study

Also Consider

Also Consider