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A new study found no significant difference in hospital quality of care during the first nine months (July 2011-March 2012) of the Centers for Medicare & Medicaid Services’ hospital value-based purchasing program (HVBP). But does the data show the whole picture?
The study, published in Health Services Research, analyzed data from five years before, and the first nine months of, value-based purchasing. No significant difference in hospital performance before and after the implementation of HVBP was found. It also found no significant difference between the value-based purchasing hospitals and hospitals that are exempt from the program (including critical access hospitals and Maryland hospitals). Due to governmental lag in reporting, the study didn’t include data after the spring of 2012, according to Kaiser Health News.
But how accurate is the study?
Though this study is the first of its kind to focus solely on the effects of value-based purchasing, its time frame is severely limited. Nine months doesn't seem enough time to declare that the program had no effect. In fact, HHS reported in May of this year http://innovation.cms.gov/Files/reports/patient-safety-results.pdf significant reductions in patient harm and Medicare 30-day readmissions throughout 2012, and attributed those results, in part, to hospital value-based purchasing. Not going beyond the first nine months also means the authors do not know whether the continually increasing penalty rates caused hospitals to buckle down on quality improvement. The authors themselves acknowledge that it could take longer to see how much hospitals will respond to the incentives and penalties of the program. Hopefully, the authors will do a follow-up using more recent data.