Noteworthy News

Safety-Net Hospitals Could Lose Ground Under New Medicare Payment Plan

WheelchairThe value-based purchasing program that Medicare plans to unroll in October could result in reduced payments to the nation’s safety-net hospitals.

A report published in the Archives of Internal Medicine found that safety-net hospitals receive lower scores in measures that Medicare will use as part of its new value-based purchasing program.  Those scores are based on data from the Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey.

As a result of those lower scores, the article “Patient Experience in Safety-Net Hospitals:  Implications for Improving Care and Value-Based Purchasing” concluded that safety-net hospitals could receive lower Medicare payments that could affect their financial health.

The National Association of Urban Hospitals (NAUH) reached a similar conclusion and has shared its concerns with the use of HCAHPS data in Medicare’s value-based purchasing program.  In a June 25 letter to the Centers for Medicare & Medicaid Services (CMS), NAUH wrote that the proposed value-based purchasing program lacks adequate risk adjustment that “must reflect the additional challenges posed by the patients served by urban safety-net hospitals.”

That value-based purchasing program, NAUH wrote,

…does not recognize the additional medical challenges these patients pose; it does not recognize the follow-up and after-care challenges these patients pose; and it does not recognize the stark reality that people living in poverty and with limited access to care are fundamentally harder to treat than the typical Medicare beneficiary.

In its June 25 letter, NAUH also questioned the value of the HCAHPS survey on which the program will rely.  NAUH wrote that

In some instances, we believe the survey’s questions are biased against large urban hospitals; in others, we believe the manner in which the survey’s findings are weighted is biased against large urban hospitals.

Read a Kaiser Health News on the new study here; read the Archives of Internal Medicine report itself here; and read NAUH’s letter to CMS expressing its reservations about the proposed Medicare value-based purchasing program here.

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