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Health Aff (Millwood). 2015 Aug;34(8):1281-8. doi: 10.1377/hlthaff.2015.0158.

Assessing Medicare's hospital pay-for-performance programs and whether they are achieving their goals.

Author information

1
Charles N. Kahn III (ckahn@fah.org) is president of the Federation of American Hospitals, in Washington, D.C.
2
Thomas Ault is a principal at Health Policy Alternatives Inc., in Washington, D.C.
3
Lisa Potetz is a principal at Health Policy Alternatives Inc.
4
Thomas Walke is a principal at Health Policy Alternatives Inc.
5
Jayne Hart Chambers is a senior vice president of quality at the Federation of American Hospitals.
6
Samantha Burch was a vice president of legislation and health information technology at the Federation of American Hospitals when this study was performed. She is now senior director, congressional affairs, at the Health Information Management Systems Society, in Chicago, Illinois.

Abstract

Three separate pay-for-performance programs affect the amount of Medicare payment for inpatient services to about 3,400 US hospitals. These payments are based on hospital performance on specified measures of quality of care. A growing share of Medicare hospital payments (6 percent by 2017) are dependent upon how hospitals perform under the Hospital Readmissions Reduction Program, the Value-Based Purchasing Program, and the Hospital-Acquired Condition Reduction Program. In 2015 four of five hospitals subject to these programs will be penalized under one or more of them, and more than one in three major teaching hospitals will be penalized under all three. Interactions among these programs should be considered going forward, including overlap among measures and differences in scoring performance.

KEYWORDS:

Hospitals; Medicare; Organization and Delivery of Care; Quality Of Care

PMID:
26240240
DOI:
10.1377/hlthaff.2015.0158
[Indexed for MEDLINE]

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