Value-based purchasing could hurt safety nets

With the hospital value-based purchasing (VBP) program set to launch in October, safety-net hospitals could take huge revenue hits for Medicare reimbursements tied to performance measures.

Reimbursement penalties are likely under the new VBP rules because safety nets scored lower than other hospitals on almost every measure of patient experience, according to a new study published in the Archives of Internal Medicine.

For the overall hospital rating, patients at safety-net hospitals were less likely to give the facility a nine or 10 on a 10-point scale than patients at other hospitals. They also were less likely to report receiving discharge information compared to patients at non-safety nets.

The study also found that safety nets had a 60 percent lower chance of meeting VBP benchmarks for hospital payments than other hospitals, according to the research announcement.

"Despite the greater need to deliver patient-centered care for vulnerable populations at SNHs, our findings suggest that these hospitals are failing to do so," the authors wrote.

The low scores are troubling, as patient satisfaction will determine 30 percent of the incentive payments under VBP, and improved clinical outcomes will decide 70 percent.

Therefore, the authors note that safety nets may need to adopt specific quality-improvement programs to boost patient experience and satisfaction.

Some techniques to improve patient satisfaction scores include establishing checklists to make sure clinical process of care measures are met and documented and utilizing call center follow-up to improve care coordination, intervention and data management.

However, an April study in Circulation: Cardiovascular Quality and Outcomes revealed that patient satisfaction and quality are not always aligned. Without a better understanding of what contributes to poor performance, according to the study authors, pay-for-performance and value-based initiatives could backfire and could even adversely affect patient care, FierceHealthcare previously reported.

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