Report: 'Faint correlation' between CMS readmissions, quality programs

Low readmission rates do not predict success in VBP program

Many hospitals that received high marks for avoiding readmissions did not fare well on CMS's process-of-care measures, according to a Modern Healthcare analysis.

The analysis compared hospitals' performance on Medicare's value-based purchasing (VBP) program and its readmissions reduction programs. It evaluated data from the nearly 3,000 hospitals that Medicare graded under the two programs.

Altogether, the Modern Healthcare analysis revealed a weak likelihood that hospitals will succeed under both quality-focused initiatives.

More than 40% of hospitals that earned bonuses under VBP faced the maximum 1% payment penalty under the readmissions reduction program. A similar percentage of hospitals that did not pay penalties for high readmission rates did pay them for poor VBP scores.

Some experts attribute the weak link between the two programs to the 12 clinical process measures used to determine payments under VBP. Others note that readmissions may be a better indicator of the care that patients receive in the 30 days after discharge.

Kay Wagner—director of quality at MidMichigan Health—says that the weak correlation between performance in the two quality initiatives suggests that the programs' quality measures are still in their infancy.

The care measures for each program "might not be directly correlated with each other right now, but it's a good beginning and I know they'll continue to improve," says Heather Van Housen, vice president of patient care at Ukiah Valley Medical Center, adding, "I do think the correlation will become tighter later on" (Evans/McKinney, Modern Healthcare, 1/5 [subscription required]).


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