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      Medicare's new hospital value-based purchasing program is likely to have only a small impact on hospital payments.

      1 ,
      Health affairs (Project Hope)
      Health Affairs (Project Hope)

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          Abstract

          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.

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          Author and article information

          Journal
          Health Aff (Millwood)
          Health affairs (Project Hope)
          Health Affairs (Project Hope)
          1544-5208
          0278-2715
          Sep 2012
          : 31
          : 9
          Affiliations
          [1 ] Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, and University of Pennsylvania, Philadelphia, USA. rwerner@upenn.edu
          Article
          31/9/1932
          10.1377/hlthaff.2011.0990
          22949441
          4cf7067e-896b-4c22-8019-707b0c5831d1
          History

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