The Hospital Value-Based Purchasing Program: Do hospitalists improve health care value

Area of Science:

• Health Services Research
• Hospital Management
• Quality Improvement

Background:

• Healthcare organizations are exploring the benefits of increasing hospitalist workforces.
• Understanding the impact of hospitalist staffing on patient outcomes and quality metrics is crucial.
• Limited data exists on how hospitalist utilization affects performance in programs like the CMS Hospital Inpatient Value-Based Purchasing (HVBP) Program.

Purpose of the Study:

• To examine the association between hospitalist staffing levels and HVBP scores.
• To investigate the influence of hospitalist ratios on Total Performance Scores (TPS) and its domains between 2014 and 2019.

Main Methods:

• A cross-sectional panel study design was employed.
• Data from 2126 hospitals were analyzed using random-effects multivariable panel regression and zero-inflated negative binomial regression.
• Hospitalist-staffing ratios were examined in relation to HVBP scores, adjusting for hospital characteristics.

Main Results:

• Hospitals with higher hospitalist-staffing ratios demonstrated significant improvements in overall TPS (β=5.40; p<.001).
• Positive associations were found with the Patient Experience (β=2.49; p<.05) and Efficiency (IRR=1.41; p<.001) domains.
• No significant difference was observed in the Clinical Care domain based on hospitalist staffing levels.

Conclusions:

• Employing a larger hospitalist workforce is associated with enhanced Total Performance Scores, improved patient experience, and greater efficiency.
• Healthcare managers should consider leveraging hospitalist expertise to optimize care processes and quality.
• Further research may explore strategies to maximize hospitalist impact across all quality domains.