TY - JOUR
T1 - Does value-based purchasing affect US hospital utilization pattern
T2 - A comparative study
AU - Hamadi, Hanadi
AU - Spaulding, Aaron
AU - Haley, D. Rob
AU - Zhao, Mei
AU - Tafili, Aurora
AU - Zakari, Nazik
N1 - Hamadi, H., Spaulding, A., Haley, D.R., Zhao, M., Tafili, A., Zakari, N. (2017) Does Value-based Purchasing Affect U S Hospital Utilization Pattern: A Comparative Study. International Journal of Healthcare Management, 12(2), 148-154.https://doi.org/10.1080/20479700.2017.1371388
PY - 2017
Y1 - 2017
N2 - We evaluated the effect US hospital performance as measured by the Medicare hospital value-based purchasing (HVBP) program has on the volume of hospitals inpatient and outpatient services. We analyzed data from the 2013 to 2014 American Hospital Association database, HVBP total performance scores database through Centers for Medicare and Medicaid Services (CMS) and the area health resources files database through CMS. This study utilized a multinomial logistic regression and transaction cost economic theory, adjusting for the Herfindahl–Hirschman Index, number of facility beds, beds per thousand, individuals 65+, teaching status, location, ownership, and system affiliation. The prominent study findings indicate a significant relationship between percent utilization of inpatient, outpatient and HVBP score. Furthermore, environmental factors such as the Herfindahl–Hirschman Index, and system participation were found to significantly impact hospitals ratio of inpatient to outpatient. Relative risk ratios show that hospitals with overall lower HVB are more likely to be in the top 25 percentile for outpatient services. With the decline in inpatient volume of services and the rise in outpatient utilization, inpatient metrics will continue to be relevant as key indicators of quality of care. Inpatient services will never become irrelevant to the overall financial profile of hospital performance.
AB - We evaluated the effect US hospital performance as measured by the Medicare hospital value-based purchasing (HVBP) program has on the volume of hospitals inpatient and outpatient services. We analyzed data from the 2013 to 2014 American Hospital Association database, HVBP total performance scores database through Centers for Medicare and Medicaid Services (CMS) and the area health resources files database through CMS. This study utilized a multinomial logistic regression and transaction cost economic theory, adjusting for the Herfindahl–Hirschman Index, number of facility beds, beds per thousand, individuals 65+, teaching status, location, ownership, and system affiliation. The prominent study findings indicate a significant relationship between percent utilization of inpatient, outpatient and HVBP score. Furthermore, environmental factors such as the Herfindahl–Hirschman Index, and system participation were found to significantly impact hospitals ratio of inpatient to outpatient. Relative risk ratios show that hospitals with overall lower HVB are more likely to be in the top 25 percentile for outpatient services. With the decline in inpatient volume of services and the rise in outpatient utilization, inpatient metrics will continue to be relevant as key indicators of quality of care. Inpatient services will never become irrelevant to the overall financial profile of hospital performance.
KW - US hospitals
KW - Value-based purchasing
KW - affordable care act
KW - hospital utilization pattern
KW - inpatient services
KW - outpatient services
KW - pay for performance
KW - total performance score
U2 - 10.1080/20479700.2017.1371388
DO - 10.1080/20479700.2017.1371388
M3 - Article
SN - 2047-9700
VL - 12
SP - 148
EP - 154
JO - International Journal of Healthcare Management
JF - International Journal of Healthcare Management
IS - 2
ER -