Identifying Centers of Excellence in Efficiency and Quality in coronary revascularization: an exploratory approach for procedure-specific value-based purchasing program design.

The advent of the value-based purchasing (VBP) concept in which efficiency and quality are considered prompted an interest in exploring approaches that incorporate both. This study examined a hospital classification method, Centers for Excellence in Efficiency and Quality (CEEQs), for coronary revascularization procedures. The results identified select hospitals (two [out of 33] in coronary artery bypass graft surgery (CABG) and seven in percutaneous coronary intervention (PCI)) that can be classified as CEEQs. Furthermore, an investigation of hospitals' efficiency and quality revealed great variation in efficiency among high-quality hospitals. The study demonstrated the possibility of employing service- or disease-specific approaches to VBP and pay-for-performance (P4P) programs.