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 is tracking 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. Find below 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:

Hospital Acquired Condition (HAC) Reduction Program:

2017: Latest Hospital Injury Penalties Include Crackdown On Antibiotic Resistant Germs
Medicare reduced payments to 769 hospitals in the program, punishing facilities that have high rates of patient injuries, including infections, blood clots, falls and bed sores. This year, federal officials also added the prevalence of two dangerous bacteria.

PDF: 2017 HAC Penalty Chart

XLS: 2017 HAC Penalty Spreadsheet

LIST: 2017 758 Hospitals Penalized For Patient Safety 

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. | Full List of 758 Hospitals Penalized

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. | Full List of 721 Hospitals Penalized


Medicare Readmissions Program:

2017: Under Trump, Hospitals Face Same Penalties Embraced By Obama 
Federal records show that 2,573 hospitals around the country will have their Medicare payments reduced because they have too many patients readmitted.

2017 Medicare Readmission Penalties By Hospital (.csv)

2017 Medicare Readmissions By State (.csv)

Half Of Nation’s Hospitals Fail Again To Escape Medicare’s Readmission Penalties

Medicare will withhold an estimated $528 million in 2017 from more than 2,500 hospitals that have too many patients returning within 30 days.

2016 Ratings: Half Of Nation’s Hospitals Fail Again To Escape Medicare’s Readmission Penalties

2015 Ratings: Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties


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