Association between value-based purchasing score and hospital characteristics.

Area of Science:

• Health Services Research
• Healthcare Policy
• Hospital Management

Background:

• The Medicare hospital Value-Based Purchasing (VBP) program links payment to quality of care, starting in 2013.
• It remains unclear how hospital characteristics affect VBP scores and incentive payments.

Purpose of the Study:

• To assess the association between hospital characteristics and mean VBP scores.
• To evaluate the relationship between hospital characteristics and specific percentiles of the VBP score distribution.
• To quantify associations with VBP score components: clinical process of care (CPC) and patient satisfaction scores.

Main Methods:

• An observational analysis using data from Medicare Hospital Compare, AHA Annual Survey, and Medicare Impact File.
• Included 2,491 U.S. acute care hospitals eligible for the VBP program.
• Employed ordinary least squares (OLS) regression for mean scores and quantile regression (QR) for score percentiles.

Main Results:

• Significant variations in VBP scores were observed.
• For-profit status, smaller bed size, and specific regions (e.g., East South Central) were positively associated with higher mean VBP scores.
• Total reported CPC measures, larger bed sizes (400-499), and certain regions were negatively associated with mean VBP scores. QR showed differential effects across quality levels.

Conclusions:

• Hospital profit status, geographic region, and the number/type of reported CPC measures were the primary drivers of VBP score variation.
• While hospitals serving disadvantaged populations may score lower, the correlation was small.
• Findings highlight key characteristics influencing VBP performance.