Young-Rock Hong1, Oliver Nguyen2, Sandhya Yadav1, Emma Etzold1, Jihee Song3, R Paul Duncan1, Kea Turner4,5. 1. Department of Health Services Research, Management, and Policy, University of Florida College of Public Health and Health Professions, Gainesville, FL. 2. Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL. 3. Family, Youth and Community Sciences Department, University of Florida College of Agricultural and Life Sciences, Gainesville. 4. Department of Health Outcomes and Behavior, Moffitt Cancer Center. 5. Department of Oncological Sciences, University of South Florida Morsani College of Medicine, Tampa, FL.
Abstract
BACKGROUND: Under the Affordable Care Act, the Centers for Medicare and Medicaid Services has greatly expanded inpatient fee-for-value programs including the Hospital Value-based Purchasing (HVBP) program. Existing evidence from the HVBP program is mixed. There is a need for a systematic review of the HVBP program to inform discussions on how to improve the program's effectiveness. OBJECTIVE: To review and summarize studies that evaluated the HVBP program's impact on clinical processes, patient satisfaction, costs and outcomes, or assessed hospital characteristics associated with performance on the program. DESIGN: We searched the MEDLINE/PubMed, Scopus, ProQuest database for literature published between January 2013 and July 2019 using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RESULTS: Of 988 studies reviewed, 33 studies that met the selection criteria were included. A small group of studies (n=7) evaluated the impact of the HVBP program, and no impact on processes or patient outcomes was reported. None of the included studies evaluated the effect of HVBP program on health care costs. Other studies (n=28) evaluated the hospital characteristics associated with HVBP performance, suggesting that safety-net hospitals reportedly performed worse on several quality and cost measures. Other hospital characteristics' associations with performance were unclear. CONCLUSIONS: Our findings suggest that the current HVBP does not lead to meaningful improvements in quality of care or patient outcomes and may negatively affect safety-net hospitals. More rigorous and comprehensive adjustment is needed for more valid hospital comparisons.
BACKGROUND: Under the Affordable Care Act, the Centers for Medicare and Medicaid Services has greatly expanded inpatient fee-for-value programs including the Hospital Value-based Purchasing (HVBP) program. Existing evidence from the HVBP program is mixed. There is a need for a systematic review of the HVBP program to inform discussions on how to improve the program's effectiveness. OBJECTIVE: To review and summarize studies that evaluated the HVBP program's impact on clinical processes, patient satisfaction, costs and outcomes, or assessed hospital characteristics associated with performance on the program. DESIGN: We searched the MEDLINE/PubMed, Scopus, ProQuest database for literature published between January 2013 and July 2019 using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RESULTS: Of 988 studies reviewed, 33 studies that met the selection criteria were included. A small group of studies (n=7) evaluated the impact of the HVBP program, and no impact on processes or patient outcomes was reported. None of the included studies evaluated the effect of HVBP program on health care costs. Other studies (n=28) evaluated the hospital characteristics associated with HVBP performance, suggesting that safety-net hospitals reportedly performed worse on several quality and cost measures. Other hospital characteristics' associations with performance were unclear. CONCLUSIONS: Our findings suggest that the current HVBP does not lead to meaningful improvements in quality of care or patient outcomes and may negatively affect safety-net hospitals. More rigorous and comprehensive adjustment is needed for more valid hospital comparisons.
Authors: Teresa M Waters; Natalie Burns; Cameron M Kaplan; Ilana Graetz; Joseph Benitez; Roberto Cardarelli; Michael J Daniels Journal: BMC Health Serv Res Date: 2022-07-28 Impact factor: 2.908
Authors: Alyssa Pozniak; Eric Lammers; Purna Mukhopadhyay; Chad Cogan; Zhechen Ding; Rashmi Goyat; Katherine Hanslits; Nan Ji; Yan Jin; Kaitlyn Repeck; Jillian Schrager; Eric Young; Marc Turenne Journal: JAMA Health Forum Date: 2022-09-02