Association between degree of exposure to the Hospital Value Based Purchasing Program and 30-day mortality: experience from the first four years of Medicare’s pay-for-performance program

Table 4 Association of HVBP with 30-day risk adjusted mortality rate for acute myocardial infarction (AMI), heart failure (HF), and pneumonia– full regression results

	AMI	HF	Pneumonia
High Medicare share hospitals	−0.056 (0.10)	− 0.113 (0.08)	−0.200* (0.10)
Post-HVBP	−2.057* (0.11)	0.467* (0.09)	−0.105 (0.08)
High Medicare share hospitals x Post-HVBP	0.031 (0.08)	0.039 (0.06)	0.114 (0.08)
Teaching hospital	−0.143 (0.12)	− 0.087 (0.11)	0.019 (0.13)
Government non-federal (ref: not-for-profit)	0.358* (0.10)	0.098 (0.08)	0.518* (0.12)
For-profit (ref: not-for-profit)	0.249* (0.09)	−0.202* (0.08)	0.126 (0.10)
Bed size: 100–199 (ref: < 100)	0.304* (0.12)	−0.033 (0.08)	−0.121 (0.11)
Bed size: > = 200 (ref: < 100)	0.306* (0.12)	−0.066 (0.09)	−0.011 (0.12)
Midwest (ref: Northeast)	0.061 (0.09)	0.229* (0.09)	0.017 (0.10)
South (ref: Northeast)	0.442* (0.11)	0.517* (0.10)	0.469* (0.12)
West (ref: Northeast)	0.056 (0.10)	0.543* (0.10)	0.238* (0.12)
DSH %	0.869* (0.23)	−0.542* (0.17)	−0.131 (0.20)
Average daily census	−0.002* (0.0002)	−0.002* (0.0003)	− 0.002* (0.0003)
Poverty rate	0.011 (0.018)	0.006 (0.02)	−0.005 (0.02)
Unemployment rate	0.007 (0.023)	−0.035 (0.02)	−0.008 (0.02)
N	11,600	14,960	15,048

Sources: Authors’ analysis of Hospital Compare (2009–2016), American Hospital Association Annual Survey (2009), and Final Impact Rules (2009–2016) data
High Medicare share hospitals: Hospitals with Medicare share inpatient days > = 55%; Low Medicare share hospitals: Hospitals with Medicare share inpatient days < 55%
Post-HVBP refers to the period 2011–2016
Estimates from random effects model reported; heteroscedasticity-robust standard errors clustered at the hospital level; model includes year dummies
The difference-in-differences estimates are indicated in bold
*p < 0.05
^aStandard errors in parenthesis

ISSN: 1472-6963