Safety-Net Hospitals may not fare well under Value-Based Purchasing

SafetyNet Hospitals may not fare well under Value-Based Purchasing, according to a study in the Archives of Internal Medicine.

For the study, researchers examined Patient Experience HCAHPS Survey data from safety-net hospitals, which were defined as hospitals in the highest quartile of the Disproportionate Share Hospital (DSH) index, and compared the results to non-safety net hospitals. 

The study found patients in safety-net hospitals were less likely to rate the hospital a 9 or 10 on a 10-point scale compared with patients in non-safety-net hospitals (63.9% vs 69.5%).  It also showed that safety-net patients were less likely to report that they had received discharge instructions, and less likely to rate communication with their physician a 9 or a 10. 

The authors note that if safety-net hospitals are unable to improve  patients experiences, hospital-based incentive programs such as value-based purchasing are likely to disproportionately penalize these institutions.

(Sources: The Advisory Board Daily Briefing,, July 18, 2012; Archives of Internal Medicine,, July 2012)