Hospitals under readmissions, HCAHPS penalties should look at per-bed risk

Hospitals could face $1.6 billion in penalties related to readmissions and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, according to a survey released today by CipherHealth. Based on data from the American Hospital Association, Kaiser Family Foundation and CipherVoice patient surveys, the health technology developer found "surprising results," it said in a company announcement, that risk should be based on a per-bed analysis.

For example, West Virginia's statewide risk is relatively low, ranking 32nd when compared to the rest of the country's three-year risk totals (of more than $3,500 per inpatient bed) for hospital readmissions and HCAHPS. However, judging quality based on the average per-bed risk, West Virginia is among the highe­st state averages in the nation.

In Texas, as well as California, there is wide variation, CipherHealth noted. For instance, Tenet Healthcare, a health system in 11 states, has an amount at risk per bed of $2,203 overall. In Texas, though, Tenet facilities have a risk-per-bed amount of $1,481.

With 39 percent of hospitals running at a loss in 2011, conceptualizing risk in a different way could help hospitals prioritize their goals under new legislation, according to company founder Zachary Silverzweig.

"I suggest we look at [value-based purchasing] in a much different way, not as a reward or punishment, a catalyst or a curse, but rather approach these [VBP] letters in a way they can make a difference for our patients and families and for healthcare overall," Jason A. Wolf, executive director of The Beryl Institute and blogger for Hospital Impact, wrote in last week's blog post. "I do challenge you to reconsider VBP and not see it as something you are "required" to do to gain financial reward. Instead I encourage you to focus on the key ideas that will drive a quality patient experience from the start," Wolf explained.

Starting in October, hospitals will face penalties for readmissions for heart attack, heart failure and pneumonia. Patient satisfaction also will determine incentive payments, in which 44 percent of U.S. hospitals participate in CMS' HCAHPS survey.

For more information:
- see the company announcement

Related Articles:
3 reimbursement changes for hospital performance
Patient satisfaction, quality not always aligned
Hospitals underestimate threat of HCAHPS penalties
Hospitals brace for Medicare targets on high readmission rates
Hospitals ready for value-based purchasing with higher patient satisfaction

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