Resource Dependency and Hospital Performance in Hospital Value-Based Purchasing.

Area of Science:

• Health Services Research
• Healthcare Management
• Health Economics

Background:

• The Centers for Medicare & Medicaid Services (CMS) established the Hospital Value-Based Purchasing (HVBP) program to incentivize quality care and manage healthcare resources.
• Understanding external environmental influences on hospital performance within value-based purchasing initiatives is crucial for effective healthcare policy.

Purpose of the Study:

• This study evaluates the impact of the external environment on hospital performance metrics within the CMS Hospital Value-Based Purchasing (HVBP) program.
• The research applies Resource Dependency Theory to analyze how external factors affect hospitals' HVBP scores.

Main Methods:

• Data were sourced from the 2014 American Hospital Association (AHA) Annual Survey, Area Health Resource File (AHRF), Medicare Final Rule Standardizing File, and Medicare Hospital Compare.
• Multiple regression analysis was employed to assess the associations between environmental variables and hospital performance scores in the HVBP program.

Main Results:

• Hospital performance scores within the HVBP program demonstrate sensitivity to environmental factors.
• The degree of influence varies across different performance domains, indicating that hospitals' ability or motivation to adapt differs.

Conclusions:

• External environmental forces significantly impact hospital performance in the Hospital Value-Based Purchasing (HVBP) program.
• Hospitals exhibit differential capacities and motivations to adjust their performance across various HVBP domains in response to environmental pressures.