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CMS Value-Based Purchasing Hasn’t Accomplished Much, says GAO

Quality Hasn’t Improved and Financial Incentive Payouts Are Minor

According to a report by the Government Accountability Office (GAO), Medicare’s value-based purchasing program has not made meaningful improvements in care in its first three years.

The financial effects have also been minimal, with nearly 75 percent of hospitals seeing an increase or decrease in Medicare payments of less than half a percentage point in the fiscal year ending Sept. 30, according to the GAO. The median penalty was $56,000 and the median bonus payment, $39,000.

As reported by FierceHealthCare, the GAO report found that hospitals with strong finances were also those that did well under the new value-based purchasing arrangements.  Hospital with a net income margin of more than 5% received average bonuses of 0.23 percent, while those that broke even either earned no extra payments or paid penalties.

Safety-net providers trailed other hospitals, although the GAO report says they have been closing the gap.

Small urban hospitals saw larger median payment adjustments than hospitals overall in all three years of the program while small rural hospitals saw adjustments roughly the same as hospitals overall for the first two years and higher in the final year.

The authors of the report note that hospital quality measures may change, especially as the program adds new ones and reduces the importance of process measures, which hospitals had little room to improve on. Hospital groups have objected to CMS quality measures as being unfair or misguided because, they contend, the measures penalize hospitals for factors outside of their control.

Source: GAO, October 1, 2015; FierceHealthCare, October 2, 2015

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