Medicare’s three hospital pay-for-performance (P4P) programs are not associated with consistent improvement in quality or patient safety measures, an AHRQ-funded study in BMC Health Services Research concluded. Researchers used 2007–2016 data from AHRQ’s Healthcare Cost and Utilization Project for 14 states to identify hospital-level inpatient quality and patient safety indicators. They also found that mortality rates generally got worse over the study period. Medicare assessed $956 million in penalties in 2019 to hospitals that failed to meet benchmarks or show improvement under the Hospital Readmission Reduction Program, the Hospital-Acquired Conditions Program and the Hospital Value-Based Purchasing Program. Given the evidence of limited impact, the cost of monitoring and enforcing penalties, and potential increase in mortality, researchers concluded that the Centers for Medicare & Medicaid Services should redesign its P4P programs before continuing to expand them.
- Combined impact of Medicare’s hospital pay for performance programs on quality and safety outcomes is mixed. BMC Health Services Research. July 2022.