Noteworthy News

Medicare Reveals First Results of Quality Program

Slightly more than half of all U.S. hospitals will receive enhanced payments from Medicare and slightly fewer than half will see their payments reduced slightly as a result of the first reporting period for Medicare’s new value-based purchasing program.

The largest bonus will be awarded to Treasure Valley Hospital, in Utah.  Each of its Medicare payments will rise 0.83 percent.  The largest penalty will be assessed to Auburn Community Hospital, in Syracuse, which will see its Medicare payments reduced 0.9 percent.  Two-thirds of all hospitals will see their payments rise or fall less than 0.25 percent.

Medicare’s value-based purchasing program, created by the Affordable Care Act, seeks to enhance provider accountability for the care they deliver.  Seventy percent of a hospital’s score is based on its performance according to 12 basic standards of care.  The rest of the score is based on the results of patient satisfaction surveys.

The program will be expanded in the coming years to encompass more standards of care.  A companion program, based on Medicare readmissions within 30 days of patient discharge, is already under way and rewarding top performance and penalizing underperforming hospitals.

The National Association of Urban Hospitals (NAUH) has conveyed to Medicare its opposition to various aspects of both the value-based purchasing program and the readmissions reduction program.  In both cases, NAUH maintains, the programs fail to reflect the special challenges urban safety-net hospitals face because so many of the low-income elderly patients they serve have had limited access to health care services throughout their lives and limited resources to manage their recovery from illnesses and injuries.  NAUH especially objects to the use of patient surveys in determining payment changes under the value-based purchasing program, maintaining that both the survey questions and the manner in which they are weighted are especially biased against large urban safety-net hospitals.

Read about NAUH’s perspective on this issue in this June 25, 2012 letter to the Centers for Medicare & Medicaid Services.

Read more about the quality program in this Kaiser Health News reportWheelchair, which also offers links to lists of the results for every hospital in the country for both the Medicare value-based purchasing and readmissions reduction programs.

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