Do ERs measure up for Medicare bonuses?

NORTHWESTERN (US) — For-profit hospitals outperform others in emergency department care—and will be more likely to get reimbursements under Medicare’s new payment rules, researchers say. 

Though nonprofit and public hospitals are lagging behind in performance, many are making noticeable improvements and will be eligible for bonuses, too, according to a study that gives an early look at how hospitals are measuring up under the new, mandatory Hospital Inpatient Value-Based Purchasing Program that went into effect October 2012.

Under the program, hospitals receive financial rewards or penalties according to achievement or improvement on several publicly reported quality measures.

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“Hospitals owned by for-profits are hitting their quality markers frequently and, therefore, will fare well under the program,” says Rahul Khare, assistant professor of emergency medicine at Northwestern University Feinberg School of Medicine and an emergency medicine physician at Northwestern Memorial Hospital.

“And though nonprofit and public hospitals scored lower on quality, many won’t lose out because they are improving.”

For the study published online in the Annals of Emergency Medicine, researchers merged 2008 to 2010 performance data from nearly 3,000 hospitals nationwide and calculated a score for each hospital based on its performance on four different emergency department measures for stroke, heart, and pneumonia.

For-profit and public hospitals had the biggest difference in performance scores. The average performance scores were 50 for for-profits, 35 for nonprofit hospitals and 30 for public hospitals. The scores of for-profit hospitals were more often driven based on achievement of quality targets. The scores for public hospitals were often driven based on improvement rather than achievement.

“The government recognizes that some public or non-profit hospitals don’t have adequate resources and is saying, ‘if you can improve you won’t be punished for lower quality scores,'” Khare says.

Source: Northwestern University