Safety-net hospitals more likely than other hospitals to fare poorly under medicare's value-based purchasing

Health Affairs

Volumn 34, Issue 3, 2015, Pages 398-405

  Gilman, Matlin ^a   Adams, E Kathleen ^a   Hockenberry, Jason M ^a   Milstein, Arnold S ^b   Wilson, Ira B ^c   Becker, Edmund R ^a  

^a EMORY UNIVERSITY   (United States)

^b STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c BROWN UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HOSPITAL; HOSPITAL CARE; HUMAN; MEDICARE; MORTALITY; PURCHASING; SAFETY NET HOSPITAL; CHI SQUARE DISTRIBUTION; CLASSIFICATION; COMPARATIVE STUDY; ECONOMICS; FACTUAL DATABASE; FINANCIAL MANAGEMENT; HEALTH CARE QUALITY; HEART FAILURE; HEART INFARCTION; HOSPITAL MORTALITY; ORGANIZATION AND MANAGEMENT; PNEUMONIA; RETROSPECTIVE STUDY; RISK ASSESSMENT; STATISTICS AND NUMERICAL DATA; TRENDS; UNITED STATES;

CHI-SQUARE DISTRIBUTION; DATABASES, FACTUAL; FINANCIAL MANAGEMENT, HOSPITAL; HEART FAILURE; HOSPITAL MORTALITY; HOSPITALS; HUMANS; MEDICARE; MYOCARDIAL INFARCTION; PNEUMONIA; QUALITY ASSURANCE, HEALTH CARE; RETROSPECTIVE STUDIES; RISK ASSESSMENT; SAFETY-NET PROVIDERS; UNITED STATES; VALUE-BASED PURCHASING;

EID: 84924588905     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2014.1059     Document Type: Article

References (24)

1. Centers for Medicare and Medicaid Services. Hospital value-based purchasing [Internet]. Baltimore (MD): CMS; 2013 Aug 9 [cited 2015 Jan 26]. Available from: http://www .cms.gov/Medicare/Quality- Initiatives-Patient-Assessment-Instruments/hospital-value-basedpurchasing/ index.html?redirect=/ hospital-value-based-purchasing.
2. Centers for Medicare and Medicaid Services. Hospital value-based purchasing program [Internet]. Baltimore (MD): CMS; 2013 Mar [cited 2015 Jan 26]. Available from: http:// www.cms.gov/Outreach-and- Education/Medicare-Learning- Network-MLN/MLNProducts/ downloads/Hospital_VB Purchasing_Fact_Sheet_ ICN907664.pdf.
3. Rau J. Medicare discloses hospitals' bonuses, penalties based on quality. Kaiser Health News [serial on the Internet]. 2012 Dec 20 [cited 2015 Jan 26]. Available from: http://www .kaiserhealthnews.org/stories/ 2012/december/21/medicarehospitals- value-based-purchasing .aspx.
4. Chatterjee P, Joynt KE, Orav EJ, Jha AK. Patient experience in safety-nethospitals: implications for improving care and value-based purchasing. Arch Intern Med. 2012;172(16): 1204-10.
5. Neuhausen K, Katz MH. Patient satisfaction and safety-net hospitals: carrots, not sticks, are a better approach. Arch Intern Med. 2012; 172(16):1202-3.
6. Gilman M, Adams EK, Hockenberry JM, Wilson IB, Milstein AS, Becker ER. California safety-net hospitals likely to be penalized by ACA value, readmission, and meaningful-use programs. Health Aff (Millwood). 2014;33(8):1314-22.
7. Goldman LE, Vittinghoff E, Dudley RA. Quality of care in hospitals with a high percent of Medicaid patients. Med Care. 2007;45(6):579-83.
8. Hasnain-Wynia R, Baker DW, Nerenz D, Feinglass J, Beal AC, Landrum MB, et al. Disparities in health care are driven by where minority patients seek care: examination of the Hospital Quality Alliance measures. Arch Intern Med. 2007;167(12): 1233-9.
9. Jha AK, Orav EJ, Li Z, Epstein AM. Concentration and quality of hospitals that care for elderly black patients. Arch Intern Med. 2007; 167(11):1177-82.
10. Anderson GF, Frogner BK. Health spending in OECD countries: obtaining value per dollar. Health Aff (Millwood). 2008;27(6):1718-27.
11. Centers for Medicare and Medicaid Services. Recovery auditing in Medicare and Medicaid for fiscal year 2012: FY 2012 report to Congress as required by section 1893(h) of the Social Security Act and section 6411(c) of the Affordable Care Act [Internet]. Baltimore (MD): CMS; 2012 [cited 2015 Jan 26]. Available from: http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Recovery-Audit-Program/Downloads/Report-To-Congress-Recovery-Auditing-in-Medicare-and-Medicaid-for-Fiscal-Year-2012_013114.pdf.
12. Berenson J, Shih A. Higher readmissions at safety-net hospitals and potential policy solutions. Issue Brief (Commonw Fund). 2012; 34:1-16.
13. Centers for Medicare and Medicaid Services. Readmissions Reduction Program [Internet]. Baltimore (MD): CMS; 2014 Aug 4 [cited 2015 Jan 26]. Available from: http:// www.cms.gov/Medicare/Medicare- Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions- Reduction-Program.html
14. Joynt KE, Jha AK. Characteristics of hospitals receiving penalties under the Hospital Readmissions Reduction Program. JAMA. 2013;309(4): 342-3.
15. Robert Wood Johnson Foundation. How does Medicare value-based purchasing work? [Internet]. Princeton (NJ): RWJF; 2012 Jun [cited 2015 Jan 26]. Available from: http://www.rwjf.org/content/dam/ farm/reports/issue_briefs/2012/ rwjf73146
16. Rau J. Methodology: how value based purchasing payments are calculated. Kaiser Health News [serial on the Internet]. 2013 Nov 14 [cited 2015 Jan 26]. Available from: http:// kaiserhealthnews.org/news/valuebased- purchasing-medicaremethodology/
17. McHugh M, Kang R, Hasnain-Wynia R. Understanding the safety net: inpatient quality of care varies based on how one defines safety-net hospitals. Med Care Res Rev. 2009; 66(5):590-605.
18. Jha AK, DesRoches CM, Shields AE, Miralles PD, Zheng J, Rosenbaum S, et al. Evidence of an emerging digital divide among hospitals that care for the poor. Health Aff (Millwood). 2009;28(6):w1160-70. DOI: 10.1377/hlthaff.28.6.w1160.
19. Jha AK. Measuring hospital quality: what physicians do? How patients fare? Or both? JAMA. 2006;296(1): 95-7.
20. Berenson RA, Pronovost PJ, Krumholz HM. Achieving the potential of health care performance measures: timely analysis of immediate health policy issues [Internet]. Princeton (NJ): Robert Wood Johnson Foundation; 2013 May [cited 2015 Jan 26]. Available from: http://www.rwjf.org/content/dam/ farm/reports/reports/2013/ rwjf406195
21. Hackbarth GM. MedPAC letter to CMS RE: file code CMS-3239-P [Internet]. Baltimore (MD): CMS; 2011 Mar 4 [cited 2015 Jan 26]. Available from: http://thehill.com/images/ stories/blogs/medpacvbpp.pdf
22. Ryan AM, Burgess JF Jr, Pesko MF, Borden WB, Dimick JB. The early effects of Medicare's mandatory Hospital Pay-for-Performance Program. Health Serv Res. 2014 Jul 15. [Epub ahead of print].
23. Ross JS, Bernheim SM, Lin Z, Drye EE, Chen J, Normand SL, et al. Based on key measures, care quality for Medicare enrollees at safety-net and non-safety-net hospitals was almost equal. Health Aff (Millwood). 2012; 31(8):1739-48.
24. Neuhausen K, Spivey M, Kellerman AL. State politics and the fate of the safety net. N Engl J Med. 2013; 369(18):1675-7.