The study authors analyzed data from the CMS Hospital Compare website to simulate the consistency of hospitals’ scores and how penalties were assigned under repeated measurement, with no change in each hospital’s underlying quality.
The simulation found only around 40 percent of the 768 hospitals subject to the program’s payment penalty last year had scores that were statistically different from the threshold penalty score.
“In other words, the majority of hospitals receiving a HAC penalty have performance indistinguishable from those that are not being penalized,” Nancy Foster, American Hospital Association vice president for quality and patient safety policy, wrote in a blog post.
The proportion of hospitals statistically different from the threshold showed significant variation when examining several factors, including the hospital’s ownership status, teaching status and bed size. The study also found that due only to chance, 18 percent of penalized hospitals would escape penalty on repeated measurement.
The study authors suggest policymakers consider alterations to the HAC-RP to improve its reliability.
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