North Texas Hospitals Penalized Under New Medicare Program Rating System

UPDATE: When initially written, this story included data for every hospital in North Texas. Unfortunately, the data used was the change in bonuses or penalties from 2013 to 2014, not the exact bonus or penalty for that specific hospital. This error was brought to our attention this morning by a hospital chain. D Healthcare Daily apologizes for the mistake.

More North Texas hospitals are receiving penalties instead of bonuses in the second year of Medicare’s quality incentive program, according to recently released CMS data.

Twenty-eight will face a penalty in their 2014 Medicare reimbursements, 19 are getting a bonus, and 18 are seeing no change. Baylor Heart and Vascular Hospital in Dallas received the top bonus, 0.59 percent, while the highest penalty went to Dallas Regional Medical Center in Mesquite, at -.93 percent.

To assess quality, Medicare looked not only at how hospitals scored in comparison with each other, but also how much each improved from two years ago compared to other hospitals. Each hospital is judged on whichever score is higher, so some hospitals with lower quality rankings are still getting more money because they showed vast improvement.

The bonuses and penalties are one piece of the Affordable Care Act’s efforts to create financial incentives for doctors and hospitals to provide better care. The rate is a combined bonus/penalty, combining the value-based purchasing element and the readmission one.

This year in Texas, hospitals—on average—will receive the same rate as last year, one of five states to see no change. On average, Maine hospitals will receive the highest bonus—.24 percent—while Wyoming hospitals will see the largest penalty, an average of -.37 percent.

And as the reimbursement stakes continue to rise, Dallas-Fort Worth hospitals are making changes.

JPS Health Network recently hired an executive director of patient experience, a new department that includes three project coordinators. A patient experience curriculum is being created and will be rolled out during new employee orientation this month.

“We are in the process of evolving our culture,” Dianna Prachyl, vice president of community health for JPS, told D Healthcare Daily in September. “We’re not going to be serving our patients fancy coffees and giving them pedicures. We are going to deliver the care they need in a compassionate manner.”

Parkland is seeking to hire one as well.

Reigen Lox, Parkland’s project manager for value-based purchasing, said the system has created a patient satisfaction steering committee. She said the system is focusing on inpatient care first and will expand into outpatient clinics and the emergency department. Carlos Girod, an internal medicine physician and member of the Parkland steering committee, said efforts to improve patient satisfaction have met “no resistance” from physicians.

“Doctors went into medicine because they want to be excellent in customer service,” he said. ”They have a sense of pride and want to improve their [satisfaction] scores.”

For the bonuses and penalties for every Texas hospital, click here. For just North Texas groups, see below.

Baylor Health Care System
7 will receive bonuses
5 will receive neither a bonus nor a penalty
3 will be penalized

Texas Health Resources
7 will receive bonuses
2 will receive neither a bonus nor a penalty
9 will be penalized

University of Texas
1 will receive neither a bonus nor a penalty
1 will be penalized

2 will receive bonuses
2 will receive neither a bonus nor a penalty
2 will be penalized