VBP's patient experience scores balance out for hospitals serving minorities

nurse with patient in a wheelchair
Nurse and patients.

When it comes to measures of patient experience, the value-based payment structure for hospitals appears to be properly balanced for facilities that treat large minority populations.

That's the conclusion of researchers with the RAND Corp., the Yale School of Medicine, the Centers for Medicare & Medicaid Services (CMS) and the Health Services Advisory Group.

Writing in the most recent issue of Health Affairs, the authors examined the performance of 3,152 acute care facilities participating in Medicare's Hospital Value-Based Purchasing (VBP) program, particularly as it pertains to Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures of the patient experience based on the care they receive. Patient experience counts for about 30 percent of the total value-based payments.

More than 1,800 hospitals nationwide this year received payment boosts as a result of the VBP initiative, up from about 1,200 in 2015. However, the Government Accountability Office noted in a report last year that many of the payments to hospitals were nominal, and that overall payments were often eclipsed by financial penalties.

However, the study noted that a significant part of this gap is made up in payments related to how the patient experience is improved and its overall consistency.

“Consistency points were a larger proportion of below-average hospitals’ total points (58.5 percent) than of above-average hospitals’ total points (33.4 percent),” the study observed. However, hospitals that served large minority populations tended to have lower HCAHPS scores overall compared to hospitals that served a majority of white patients.

“The findings from our analysis demonstrate that the HCAHPS payment structure in the CMS Hospital VBP program is working as intended—to reduce undesired effects and to increase engagement by lower-performing hospitals in quality improvement,” the report concluded. “Improvement and consistency points play small but important roles in HCAHPS scores and corresponding incentive payments, especially for hospitals with below-average HCAHPS performance.”