The unintended consequences of The Centers for Medicare and Medicaid Services pay-for-performance structures on safety-net hospitals and the low-income, medically vulnerable population.
Safety-net hospitals are hospitals with patient mix that is substantially composed of the uninsured, underinsured, and low-income, medically vulnerable patient populations. They are the hospitals of last resort for poor patients. This article examined the impact of The Centers for Medicare and Medicaid Services pay-for-performance reimbursement policies on the financial viability of safety-net hospitals. Studies showed that these policies, which are based on the principle of reward and punishment, might have unintentionally placed safety-net hospitals on financial disadvantage compared to other hospital organizations. Several studies implied that these payment structures might have resulted in a situation where safety-net hospitals that are serving poor patient populations become more susceptible to penalties than hospitals that are serving affluent patients.
College of Health and Human Services, The University of North Carolina at Charlotte, NC, USA.
Elmer B
EB
Fos
D014487:Centers for Medicare and Medicaid Services, U.S.; D006801:Humans; D008484:Medicaid; D006278:Medicare; D011203:Poverty; D012052:Reimbursement, Incentive; D064876:Safety-net Providers; D014481:United States; D035862:Vulnerable Populations
hospital readmission; hospital-acquired infection; low-income; medically vulnerable population; pay-for-performance; safety-net hospital; value-based purchasing