Report Analyzes Hospital Pay-for-Performance Results

An impact analysis of five hospital Pay-for-Performance programs on 3,218 hospitals across the U.S. shows a one-year savings of $930 million to the Medicare program. The Greater New York Hospital Association (GNYHA) analyzed the affects of five hospital P4P programs now in operation: quality reporting, meaningful use (MU) of electronic health records, value-based purchasing, readmissions reductions and the hospital-acquired conditions/complications reduction program. Of the five programs, fully 57% of all Medicare savings in FY 2017 were attributed to the readmissions reductions program, while another 40% of savings were attributed to the hospital-acquired conditions reduction program. “The quality reporting and MU programs provide negligible savings to the Medicare program, but notable losses to affected hospitals,” wrote Elisabeth Wynn, GNYHA Senior Vice President, in written testimony submitted September 7 to the House Ways & Means Health Subcommittee. Among her critiques of the P4P programs, Wynn argues against a complicated reporting structure in which “each program has its own relatively sophisticated scoring methodology that embeds different policy preferences.” Wynn argues that safety net hospitals are disadvantaged by patient experience measures that account for as much as 25% of a hospital’s total value-based purchasing score, and by risk-adjustments that downgrade experience scores offered by less educated, non-English speaking patients in poor health. For a copy of the GNYHA testimony presented at the Ways & Means’ Hearing on Incentivizing Quality Outcomes in Medicare Part A, visit the association’s website at www.gnyha.org.