Value-based purchasing program hasn't improved patient experience, study finds

Even though CMS' Hospital Value-Based Purchasing program linked patient experience scores to hospital reimbursement, the program hasn't seemed to spur much improvement in HCAHPS scores, according to an analysis published in Health Affairs.

Researchers examined publicly reported HCAHPS data representing patients discharged between January 2008 and the end of December 2014. They focused on performance in two measures — overall experience, which is used in the VBP program, and willingness to recommend, which is not incentivized under the VBP program — and looked at improvement before and after the first VBP performance period started in July 2011.

They found overall patient experience ratings for all hospitals increased by 6.1 percentage points during the time period. However, overall rating improved at a faster rate before the intervention period (1.49 percent compared to 0.55 percent).

"We found no evidence to suggest that implementing Medicare's Hospital Value-Based Purchasing Program accelerated the improvement of patient experience beyond secular trends, even among the hospitals with the poorest performance at baseline," the study concludes. "Instead, we found that the rate of improvements in patient experience has slowed since the program was implemented."

The study's authors suggest stronger incentives or more narrowly focused metrics are necessary to clarify how to best spur hospitals to improve patient experience.

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