Noteworthy News

New Medicare Wrinkle May Harm Urban Safety-Net Hospitals

A new Medicare program that bases payments to hospitals in part on patient satisfaction with those hospitals could be especially harmful to urban safety-net hospitals.

The Medicare value-based purchasing program, which took effect on October 1, will withhold one percent of all hospitals’ Medicare payments and then redistribute that money based on hospitals’ compliance with selected standards-of-care requirements and on the results of surveys of hospitalized Medicare patients.  The withheld one percent will then be redistributed to hospitals that perform well based on these criteria.  Beginning in 2017, two percent of hospitals’ Medicare payments will be withheld and eventually redistributed in this manner.

The National Association of Urban Hospitals (NAUH) has expressed serious misgivings about this new program.  In a June 25 letter to the Centers for Medicare & Medicaid Services (CMS), NAUH wrote that

…we believe some of the survey’s questions are biased against large urban hospitals.  We think it is inappropriate, for example, to compare the degree of quietness of a seventy-five-year-old hospital with semi-private rooms located in a congested urban area with that of a new facility with private rooms located on a sylvan, multi-acre campus set well off any major thoroughfares.

NAUH also wrote that

…we believe the manner in which the responses to some questions will be weighted is biased against large urban hospitals.  We think it is unfair, for example, to downgrade the survey results from the kinds of patients urban safety-net hospitals serve in especially high numbers and proportions, such as maternity patients and those for whom English is not their native language.

The complete June 25 NAUH letter can be found here.

Learn more about the Medicare value-based purchasing program and how hospitals are preparing for the survey component of its payment adjustments in this Wall Street Journal articleWheelchair.

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