I have previously blogged about Maryland Hospitals being incentivized or penalized based on quality. Last year was the first year that hospitals fell under such a program. Nationally, hospitals will be a part of a similar program beginning in October 2012.
The impact on WMHS for FY 2012 based on 2011 performance was a $1.2M decrease in our rates. Based on a zero sum game formula, some hospitals were winners (not us) and some were losers, as was the case with WMHS. All Maryland hospitals pay into a fund and by performing better than expected on potentially preventable conditions (Medicare calls them hospital acquired conditions) such as hospital acquired infections, falls with injury and pressure ulcers, hospitals are awarded monies. Also factored in are patient satisfaction scores (HCAHPS) and core measure results. We were penalized $782K based on our quality-based reimbursement scores and over $400K for our potentially preventable conditions. Yesterday, we received this year's results based on last year's performance. After a lot of hard work and attention to detail, WMHS rates will be increased by over $200K; a turnaround of over $1.4M between last year and this year. We cannot rest on our laurels, as all hospitals in Maryland are striving to do better. Our goal is to exceed last year's performance by continually improving our core measure performance and our patient satisfaction scores and eliminating our potentially preventable conditions. Great job to our change agents at WMHS!