The CMS Pay for Performance Program (PFP) provides financial incentives to hospitals with the highest compliance for pneumonia core measures (PCM) and maintains large databases regarding compliance of individual hospitals.The present work used the PFP databases to determine if hospital classification based upon ownership (government, proprietary or non-profit) has an effect on pneumonia treatment measured by rate of compliance with the seven pneumonia core measures (PCM 1-PCM 7).
The percentage of hospitals in each group who were compliant with each PCM was determined using data from the CMS for 4248 hospitals and were analyzed as a function of hospital type using non-parametric statistics (Wilcoxon scores and Kruskal-Wallis tests).
Overall PCM compliance rates were above 70% for all three hospital groups with government hospitals having the lowest compliance percentage rates (73–98%), proprietary hospitals exhibited compliance rates of 77–99% and the non-profit hospitals having the highest percentage rates (80–99%). PCM1 (oxygen administration) had the highest compliance for all three hospital types (99 %). The lowest compliance rates were for PCM 2 and PCM 7 related to administration of pneumonia and influenza vaccines, respectively. The PCM 2 rates were 75% (government), 80% (proprietary) and 81% (non-profit). The PCM 7 rates were 73% (government), 79% (proprietary) and 80% (non-profit). Interestingly, hospitals , no matter their owner classification, that treated more patients had higher compliance rates for PCM2 and PCM7.
Classification of hospitals as a function of owner type appears to significantly affect compliance with pneumonia core measures especially those related to vaccine administration. The percentage of government hospitals that are compliant with the seven PCMs is less than other types of hospitals, indicating that they are less likely to receive financial incentives from CMS. The reasons underlying less compliance of government hospitals is not clear from our study but should be investigated to help improve quality of care provided by these entities.
Hospitals need to focus on the administration of pneumonia and influenza vaccines.
Jun Chiong, No Financial Disclosure Information; No Product/Research Disclosure Information