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September 7, 2015Annals of Internal Medicine

The Financial Effect of Value-Based Purchasing and the Hospital Readmissions Reduction Program on Safety-Net Hospitals in 2014

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Why the study?

Do safety-net hospitals incur larger financial penalties than other hospitals under Medicare's value-based purchasing and the Hospital Readmissions Reduction Program?

Population

3022 acute care hospitals participating in Medicare's value-based purchasing and the Hospital Readmissions…

Comparison

Safety-net hospital status (defined as being in… vs Other hospitals not meeting the safety-net…

Design

Cross-sectional

Authors

MGMatlin GilmanHarvard UniversityJHJason M. HockenberryYale UniversityEAE. Kathleen AdamsEmory University

Discussion

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Implication

May warrant policy adjustments to ease burdens on safety-net hospitals; cross-sectional data leave open whether reforms would reduce disparities.

Structured PICO

Do safety-net hospitals incur larger financial penalties than other hospitals under Medicare's value-based purchasing and the Hospital Readmissions Reduction Program?

P
Population
3022 acute care hospitals participating in Medicare's value-based purchasing (VBP) and the Hospital Readmissions Reduction Program (HRRP) in the United States in 2014.
I
Intervention
Safety-net hospital status (defined as being in the top quartile of the Medicare disproportionate share hospital (DSH) patient percentage and Medicare uncompensated care (UCC) payments per bed)
C
Comparator
Other hospitals not meeting the safety-net definition
O
Outcome
Differences in financial penalties in both total dollars and dollars per bed under VBP and HRRP

Safety-net hospitals were disproportionately penalized under Medicare's value-based purchasing and Hospital Readmissions Reduction Program in 2014, although most incurred relatively small payment penalties.

Limitations

  • Only 2 measures of safety-net status were included in the analyses.

Cite This Study

Gilman et al. (2015) studied this question.

synapsesocial.com/papers/6a73baba0375516f85f157b5https://doi.org/10.7326/m14-2813
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