Understanding The Role Played By Medicare's Patient Experience Points System In Hospital Reimbursement.
In 2015 the Medicare Hospital Value-Based Purchasing (VBP) program paid hospitals $1.4 billion in performance-based incentives; 30 percent of a hospital's VBP Total Performance Score was based on performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures of the patient experience of care. Hospitals receive patient experience points based on three components: achievement, improvement, and consistency. For 2015 we examined how the three components affected reimbursement for 3,152 hospitals, including their impact on low-performing and high-minority hospitals. Achievement accounted for 96 percent of the differences among hospitals in total HCAHPS points. Although achievement had the biggest influence on payments, payments related to improvement and consistency were more beneficial for low-performing hospitals that disproportionately served minority patients. The findings highlight the important inducement that paying for improvement provides to initially low-performing hospitals to improve care and the role this incentive structure plays in minimizing resource redistributions away from hospitals serving minority populations. Additional emphasis on improvement points could benefit hospitals serving disadvantaged patients.
Marc N. Elliott (elliott@rand.org) is a senior principal researcher in health at the RAND Corporation in Santa Monica, California.
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Megan K. Beckett is a behavioral social scientist at the RAND Corporation.
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William G. Lehrman is a health insurance specialist in the Division of Consumer Assessment and Plan Performance, Centers for Medicare and Medicaid Services, in Baltimore, Maryland.
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Paul Cleary is dean of the Yale University School of Public Health, in New Haven, Connecticut.
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Christopher W. Cohea is a senior research analyst in surveys, research, and analysis at the Health Services Advisory Group, in Phoenix, Arizona.
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Laura A. Giordano is vice president for surveys, research, and analysis at the Health Services Advisory Group.
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Elizabeth H. Goldstein is director of the Division of Consumer Assessment and Plan Performance, Centers for Medicare and Medicaid Services.
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Cheryl L. Damberg is a senior principal researcher in health at the RAND Corporation.
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D032882:Comprehension; D003695:Delivery of Health Care / Q000191:economics; D004469:Economics, Hospital; D005260:Female; D006282:Health Personnel / Q000191:economics; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics*; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012051:Reimbursement Mechanisms / Q000191:economics* / Q000639:trends; D012052:Reimbursement, Incentive / Q000458:organization & administration*; D014481:United States; D062505:Value-Based Purchasing / Q000458:organization & administration*
Disparities; Health Reform; Hospitals; Quality Of Care