For-profits outperform nonprofit, public hospitals on ED measures

For-profit hospitals have an edge over nonprofit and public hospitals in receiving Medicare bonuses because they are doing better at treating emergency department patients for stroke, heart attack and pneumonia, a study from Northwestern Medicine finds.

Medicare's Hospital Inpatient Value-Based Purchasing Program, which took effect in October, measures hospital quality in several key areas, including treatment of heart attack, stroke and pneumonia.

Based on performance data from 2008 to 2010 for nearly 3,000 hospitals, Northwestern researchers found for-profit hospitals had an average performance score of 50, compared with 30 for public hospitals, the university announced. Nonprofits' scores averaged 35. The lowest scores came from hospitals lacking accreditation from The Joint Commission, according to the findings.

The researchers noted nonprofit and public hospitals are making "strong signs of improvement, signaling that performance gaps by ownership and accreditation may decrease." Many also are eligible for bonuses already.

Public hospitals, in particular, are receiving scores based on improvement, according to the research announcement, while for-profit hospitals' scores are more often based on quality.

"The government recognizes that some public or non-profit hospitals don't have adequate resources and is saying, 'If you can improve you won't be punished for lower quality scores,'" study author Rahul Khare, M.D., said in a statement.

The study was published online March 13 in the Annals of Emergency Medicine but was announced yesterday by Northwestern University's Feinberg School of Medicine.

In a separate study published earlier this year in the journal Pediatrics, researchers from Cincinnati Children's Hospital Medical Center found patient population, rather than hospital resources, was the best predictor of quality outcomes for pediatric patients. They found that sicker patients and patients with chronic conditions were larger factors than scarce resources or large numbers of Medicaid patients.

But challenges remain for safety-net hospitals, especially in urban areas. Hospitals including United Medical Center in Washington, D.C., and University Hospital in Newark N.J., are struggling to find private operating partners to ensure long-term viability.

To learn more:
- read the Northwestern announcement
- here's the study abstract