Institutional Performance

Project Descriptions

Measuring Financial Performance in Critical Access Hospitals

University of North Carolina Rural Health Research & Policy Analysis Center
Expected completion date: August 2008
Principal Investigator: Rebecca Slifkin, Ph.D., 919-966-5541 or becky_slifkin@unc.edu
Contact Person: George Pink, Ph.D., 919-966-5541 or gpink@schsr.unc.edu

This multi-year project uses research and expert opinion to select dimensions and indicators of financial performance, develop appropriate methods of peer comparison, and identify characteristics of high performing CAHs. In year five of this project (2007-08) a Financial Indicators Report will be produced that will include the results of a CAH benchmarking survey. This CAH Financial Indicators Report will be disseminated through a web-based tool maintained by the University of North Carolina, where CAH administrators will be able to access and download their report directly from the website. During this project year, alternate methods for selecting benchmarks will be assessed, and benchmarks for each financial indicator will be established.

Measuring Quality Performance for Critical Access Hospitals

University of Minnesota Rural Health Research Center
Expected completion date: August 2008
Principal Investigator: Ira Moscovice, Ph.D., 612-624-8618 or mosco001@umn.edu
Contact Person: Michelle Casey, M.S., 612-626-6252 or mcasey@umn.edu

This project continues to support activities related to quality performance measurement relevant for Critical Access Hospitals. In Year 5, we will continue and expand our quality measure analyses for CAHs using Hospital Compare data for Calendar Year 2006.

These date will be used to:

For our Year 3 and Year 4 analyses, we defined participation as providing data on at least one measure. We will extend that analysis by examining patterns of participation across measures within conditions. For example, for pneumonia, we will analyze how many CAHs report data on 1-6 measures, and the number of patients for whom data are reported for each measure.

Critical Access Hospital Readiness for CMS Value-Based Purchasing

Joint project of the University of Minnesota and the University of North Carolina
Expected completion date: August 2008
Principal Investigators: Ira Moscovice, Ph.D., 612-624-8616 or mosco001@umn.edu.edu
Rebecca Slifkin, Ph.D., 919-966-5541 or becky_slifkin@unc.edu

As required by the Deficit Reduction Act of 2005, CMS is developing a Medicare Value-based Purchasing (VBP) program for Prospective Payment System (PPS) Hospitals and preparing to implement the VBP in Fiscal Year 2009. The program will build on Medicare’s Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) Program, through which CMS provides financial incentives to PPS hospitals that publicly report their performance on a subset of the Hospital Compare quality measures. CAHs are exempt from the RHQDAPU reporting requirements, but over half of CAHs have chosen to voluntarily report quality data to Hospital Compare. CAHs also are exempt from the VBP program, and the VBP program as currently envisioned does not include an option for voluntary participation by CAHs.

The purpose of this project will be to assess CAH readiness for participation in a VBP similar to that proposed by CMS for PPS hospitals. The project will have two parts. The first part, lead by UMN, will analyze potential ways to evaluate and reward quality performance for CAHs in the VBP program. The second part, a cooperative effort of UMN and UNC, will examine the relationship between CAH quality performance, using the quality measures evaluated in the first part, and financial performance. It will assess the potential financial impact of quality performance rewards for CAHs, by describing the current financial condition of those that would receive such awards and those that would not.

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