Medicare's New Hospital Value-Based Purchasing Program Is Likely To Have Only A Small Impact On Hospital Payments

被引:48
作者
Werner, Rachel M. [1 ,2 ]
Dudley, R. Adams [3 ]
机构
[1] Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA
[2] Univ Penn, Philadelphia, PA 19104 USA
[3] Univ Calif San Francisco, Philip R Lee Inst Hlth Policy Studies, San Francisco, CA 94143 USA
基金
美国医疗保健研究与质量局;
关键词
PAY-FOR-PERFORMANCE; QUALITY IMPROVEMENT; INCENTIVES; MORTALITY; CARE;
D O I
10.1377/hlthaff.2011.0990
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Medicare's new hospital pay-for-performance program for all acute care hospitals will begin in October 2012. It will be the largest Medicare quality improvement initiative for hospitals to date. Using 2009 data on hospital performance, we calculated hospital performance scores and projected payments under the new program for all eligible hospitals. Despite differences across hospitals in terms of performance, expected changes in payments were small, even for hospitals with the best and worst performance scores. Almost two-thirds of hospitals would experience changes of just a fraction of 1 percent. Although the program will in effect redistribute resources among hospitals, our data suggest that the redistribution is not likely to cause major problems because the amount being redistributed is also small. These results raise questions about whether the new pay-for-performance program will substantially alter the quality of hospital care, and they highlight the challenges of designing effective quality improvement incentives.
引用
收藏
页码:1932 / 1940
页数:9
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