Medicare’s Value-Based Purchasing (VBP) program produced no improvement in either quality of care or patient satisfaction during its first nine months of operation. That’s the finding of a study led by Andrew Ryan, of the Department of Healthcare Policy & Research at Weill Cornell Medical College, and published in the current on-line issue of Health Services Research.
VBP is Medicare’s effort to apply both a stick and a carrot to improve quality of care and patient satisfaction in hospitals. Quality is measured by adherence to a dozen prescribed protocols. Satisfaction is determined by patient surveys. Up to 1% the first year and 1.25% this year of a hospital’s Medicare payments is at stake. That can be a lot of money.
But Ryan’s study found no significant improvement in the performance of participating hospitals—no improvement as compared to the previous five years of performance by those same hospitals and no improvement as compared to hospitals exempt from VBP (e.g., critical access hospitals).
On the bright side, though, there clearly was improvement in both quality and satisfaction. And it may be the case that the first nine months—the only period for which data were available at the time of the study—didn’t provide sufficient time to allow hospitals to fully gear up for the brave new world of VBP.
