Hospital value based purchasing scores highly associated with prior year score and organizational characteristics

Abstract

Objective: Medicare’s Hospital Value Based Purchasing program (HVBP) rewards hospitals which achieve a higher than mean Total Performance Score (TPS). This article investigates the relationship between hospital characteristics and prior year Total Performance Score (TPS) on current year TPS under Medicare’s Hospital Value Based Purchasing (HVBP) program.Methods: Regression analyses are used to investigate the relationship between prior year TPS and organizational characteristics on current year TPS.Results: Regression analyses show that certain geographic locations, smaller bed size, and lower disproportionate share hospital percentage (DSHPCT) lead to a significantly higher TPS in both FY 2015 and FY 2016. Teaching status is associated with higher scores in FY 2015 and lower scores in FY 2016. Furthermore, prior year TPS is a significant predictor of current year TPS.Conclusions: Results suggest HVBP performance is dependent upon organizational characteristics which may have little to do with quality or cost of care. Furthermore, the findings demonstrate that prior year HVBP performance is the strongest predictor of future performance which may impede low performing hospitals from achieving success in future years, despite significant gains in improving cost and quality.