The Hospital Value-Based Purchasing Program: Do hospitalists improve health care value

Authors

Aaron Spaulding, Division of Health Care Delivery Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida, USA.
Aurora Tafili, Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Ajani Dunn, Mayo Clinic College of Medicine and Science, Mayo Clinic, Jacksonville, Florida, USA.
Hanadi Hamadi, University of North FloridaFollow

Document Type

Article

Publication Date

7-1-2022

Subject Area

Aged; Cross-Sectional Studies; Delivery of Health Care; Hospitalists; Hospitals; Humans; Medicare; United States; Value-Based Purchasing

Abstract

INTRODUCTION: As healthcare organizations examine the associated benefits of employing a larger hospitalist workforce, there is a need to better understand the association with patients' quality, experience, and efficiency. However, there is a lack of information regarding how hospital use of hospitalists over time influences hospital scoring on quality programs, such as the Center for Medicare and Medicaid Services (CMS) Hospital Inpatient Value-Based Purchasing (HVBP) Program. This study examines the association between hospitalist staffing between 2014 and 2019 and HVBP scores. METHODS: We used a cross-sectional panel study design. Total Performance Score (TPS) and its domains were obtained from CMS from 2014 to 2019 and merged with the American Hospital Association Annual Survey Database. We utilized random-effects multivariable panel regression models and zero-inflated negative binomial regression to examine the association between the hospitalist-staffing ratio and the HVBP Program. All models were adjusted for hospital characteristics. RESULTS: A total of 2126 hospitals were included in the study. The average ratio of hospitalists per staffed bed was 0.06, with a standard deviation of 0.15. This study suggests that hospitals that employ a higher percentage of hospitalists see improvement in their overall TPS (β = 5.40; p < .001), Patient Experience (β = 2.49; p <.05), and Efficiency (incidence-rate ratio= 1.41; p < .001) domain. However, the Clinical Care domain was no different in organizations employing more hospitalists. CONCLUSION: There are benefits associated with TPS, Patient Experience, and Efficiency from employing hospitalists. Managers should seek opportunities to leverage hospitalists' expertise in providing care, particularly in improving care processes.

Publication Title

Journal of hospital medicine

Volume

17

Issue

7

First Page

517

Last Page

526

Digital Object Identifier (DOI)

10.1002/jhm.12892

PubMed ID

35729856

E-ISSN

1553-5606

Language

eng

Citation Information

Spaulding, Aaron; Tafili, Aurora; Dunn, Ajani; and Hamadi, Hanadi, "The Hospital Value-Based Purchasing Program: Do hospitalists improve health care value" (2022). UNF Faculty Research and Scholarship. 3206.
https://digitalcommons.unf.edu/unf_faculty_publications/3206