Paying For Hospital Quality

The government takes performance into account when paying hospitals, one of the biggest changes in Medicare’s 50-year-history. Kaiser Health News has tracked the major incentive programs created by the federal health law: penalties for hospitals that readmit too many people within 30 days, penalties for hospitals with excess numbers of patient injuries, and bonuses and penalties for hospitals based on several dozen quality measures, including patient satisfaction and death rates. KHN also provides easy-to-read charts and downloadable data sets that show Medicare’s financial actions for hospitals throughout the country.

Here are links to those articles, the charts and data:

Medicare Readmissions Program:

Half Of Nation’s Hospitals Fail Again To Escape Medicare’s Readmission Penalties
The fines, in their fourth year, are assessed on hospitals that have patients frequently return and will cost nearly 2,600 hospitals $420 million in total.

PDF: Medicare Readmission Penalties By Hospital

CSV: Medicare Readmission Penalties By Hospital

PDF: Medicare Readmission Penalties By State

CSV: Medicare Readmission Penalties By State


Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties
Although fewer patients are now returning to the hospital within a month, the fines reached a record level this year.

PDF: Readmissions Penalty Chart Year 3 

CSV: Readmissions Penalty Spreadsheet Year 3 

Methodology: A Guide To Medicare’s Readmissions Penalties And Data

Hospital Acquired Condition (HAC) Reduction Program:

2016: Medicare Penalizes 758 Hospitals For Safety Incidents
More than half of these hospitals were also punished last year as the government tries to leverage taxpayer money to improve the quality of care.

PDF: 2016 HAC Penalty Chart

XLS: 2016 HAC Penalty Spreadsheet

LIST: 2016 758 Hospitals Penalized For Patient Safety 

2015: Medicare Cuts Payments To 721 Hospitals With Highest Rates Of Infections, Injuries
The 1 percent penalty, mandated by the health law, will hit one of every seven hospitals in the country and fall particularly hard on academic medical centers.

PDF: 2015 HAC Penalty Chart

CSV: 2015 HAC Penalty Spreadsheet 

LIST: 2015: 721 Hospitals Penalized For Patient Safety

2015 Hospital-Acquired Condition Penalties By State

2015 Methodology: How Hospital-Acquired Conditions Are Calculated

Hospital Value-Based Purchasing Program 

1,700 Hospitals Win Quality Bonuses From Medicare, But Most Will Never Collect
Penalties for readmissions and patient injuries erase bonuses hospitals earn for meeting stiff quality criteria. Fewer than 800 will end up with higher payments.

PDF: Medicare Quality Bonuses And Penalties Year 3 Chart 

CSV: Medicare Quality Bonuses And Penalties Year 3 Spreadsheet

2015 State-by-State Readmissions Chart