What is it about?

The Centers of Medicare & Medicaid Services (CMS) links hospital reimbursements to quality metrics. Likewise, the Hospital Value-Based Purchasing (VBP) program offers financial incentives to acute-care hospitals based on performance improvements on several quality measures included in the national Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. A research gap exists with regard to assessing the effectiveness of VBP incentives on improving the patient’s quality of care. This study is to determine whether hospitals which reported better patient quality metrics and lower frequency of pressure sores received higher reimbursements. The results did not reveal any financial penalties when hospitals reported lower patient quality outcomes and increased numbers of pressure sores. However, lower patient quality measures were associated with lower patient satisfaction. Controversially, lower patient satisfaction scores were associated with higher reimbursement rates overall.

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Why is it important?

This study reveals that the effectiveness of value-based reimbursements and the concept of continuous improvement is constrained due to the lack of unified measurement objectives across US healthcare institutions. Stakeholders should seek to achieve a unified perspective on the definition and assessment of healthcare quality in order to enhance the long-term practices of the US healthcare industry.


Medicare VBP was established to penalize hospitals with higher patient safety index ratings. However, the hospitals are not necessarily penalized for excessively high Hospital-Acquired Condition (HAC) scores. In fact, hospitals received larger reimbursements while having higher HAC scores. Consequently, US policy makers and healthcare providers should create procedures and policies based on appropriate comparisons which are valid across all healthcare environments.

Hui-chuan Chen
University of Tennessee at Martin

Read the Original

This page is a summary of: The effect of patient quality measurements and HCAHPS patient satisfaction on hospital reimbursements, Human Systems Management, July 2023, IOS Press,
DOI: 10.3233/hsm-220042.
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