Are Safety Net Hospitals Reimbursed Fairly Under Hospital Value-Based Purchasing-Prioritizing Satisfaction Over Outcomes?

Are Safety Net Hospitals Reimbursed Fairly Under Hospital Value-Based Purchasing-Prioritizing Satisfaction Over Outcomes?

Publication date: Sep 25, 2025

The Centers for Medicare and Medicaid Services (CMS) reimburse hospitals through the Hospital Value-Based Purchasing Program (HVBP) based on clinical outcomes, safety, efficiency, and patient satisfaction, currently weighted equally. The aim is to explore whether adjusting these weights could address reimbursement inequities for safety net hospitals (SNH). We assessed 2,731 non-federal hospitals using CMS payment files. They were divided into SNH and non-SNH based on their DSH (Disproportionate Share Hospital) status in 2020. We compared both groups’ 2020 HVBP scores to ensure data accuracy and account for COVID-19 impacts. SNHs had lower person and community engagement domain scores (6. 9) compared to non-SNHs (8. 87, p

Concepts Keywords
Covid HCAHPS
Lower hospital value-based purchasing
Medicaid HVBP
Purchasing patient satisfaction
safety net hospitals

Semantics

Type Source Name
disease MESH COVID-19

Original Article

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