Medicare has two payment incentive programs for hospitals that are part of an effort to make them accountable on quality. One gives bonuses and penalties to hospitals based on how well they performed on 24 quality measures. That program is called Value Based Purchasing. The second penalizes hospitals which have too many patients readmitted within a month. Both programs are in their second year.
The changes are applied to payments for every hospital stay of a Medicare patient from October 2013 through September 2014. Hospitals could gain up to 1.25 percent in payments or lose as much as 3.25 percent from the two programs combined. This chart shows the payment adjustments for each hospital and how they compared to the bonuses and penalties from last year. The annual change is expressed as a percentage point difference. Hard dollar figures are not available because the total cost to a hospital will depend on how much it bills Medicare through next September.
The adjustments do not apply to money Medicare pays hospitals for capital expenses, to teach residents or to treat large numbers of low-income patients. Hospitals with too few cases and certain specialty hospitals, such as psychiatric, long-term care, rehabilitation and cancer hospitals, are exempted from the programs. Maryland hospitals are also excluded from the program, as that state has a unique reimbursement arrangement with Medicare, so no Maryland hospitals are listed below.
Hospitals that are not listed as being active in the Medicare program have been removed. A [1] means that Medicare did not calculate a payment adjustment for the hospital this year. A [2] means KHN could not calculate the annual change because one or both years lacked data.
The full data for individual hospitals also can be downloaded as a CSV spreadsheet. An interactive chart shows average bonuses and penalties by state. The methodology explains how Medicare determines the payments and details how KHN presents the data.
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Data source: Centers for Medicare & Medicaid Services
