Publications by authors named "Sam Krinsky"
Background: Starting in fiscal year 2013, the Hospital Value-Based Purchasing (HVBP) program introduced quality performance-based adjustments of up to 1% to Medicare reimbursements for acute care hospitals.
Methods: We evaluated whether quality improved more in acute care hospitals that were exposed to HVBP than in control hospitals (Critical Access Hospitals, which were not exposed to HVBP). The measures of quality were composite measures of clinical process and patient experience (measured in units of standard deviations, with a value of 1 indicating performance that was 1 standard deviation [SD] above the hospital mean) and 30-day risk-standardized mortality among patients who were admitted to the hospital for acute myocardial infarction, heart failure, or pneumonia.
Importance: Medicare is experimenting with numerous concurrent reforms aimed at improving quality and value for hospitals. It is unclear if these myriad reforms are mutually reinforcing or in conflict with each other.
Objective: To evaluate whether hospital participation in voluntary value-based reforms was associated with greater improvement under Medicare's Hospital Readmission Reduction Program (HRRP).
Background: Introduced in 2004, the UK's Quality and Outcomes Framework (QOF) is the world's largest primary care pay-for-performance programme. We tested whether the QOF was associated with reduced population mortality.
Methods: We used population-level mortality statistics between 1994 and 2010 for the UK and other high-income countries that were not exposed to pay-for-performance.
Article Synopsis
- The study aims to analyze how payment rates under Medicare's Inpatient Prospective Payment System vary and what factors contribute to this variation.
- It utilizes Medicare cost reports from 1987 to 2013 and geographic data to assess these payment rates and their fluctuations within different regions and hospitals.
- Findings reveal that adjustments for medical education and care for low-income populations heavily influence payment rates, with some hospitals receiving rates significantly above the standard base, and this variation has been increasing over time.