Healthcare Insights
Top 20 hospitals in value-based purchasing
Value-based purchasing, established by the Center for Medicare and Medicaid (CMS), seeks to reward hospitals by redistributing Medicare payment dollars among U.S. hospitals of the highest quality and performance.
What is the Hospital Value-Based Purchasing Program?
The Hospital Value-Based Purchasing (VBP) Program is one of several value-based care programs introduced by the Affordable Care Act. Value-based care links provider reimbursement to the quality of care they provide rather than the quantity of services they provide.
The Hospital VBP Program rewards hospitals that provide high-quality care to Medicare patients. Under the programs, hospitals receive payment adjustments based on the quality of care the hospitals deliver to patients during inpatient stays.
The payments are supported through a 2% reduction of Diagnosis-Related Group funding for participating hospitals. The money that is withheld is then distributed between eligible facilities according to performance.
Hospitals may earn an increase, decrease, or no change to their Medicare reimbursements for the following fiscal year. The actual amount of incentive payments a hospital earns is also linked to the total amount available under the program.
The performance measurement domains for the 2021 Hospital VBP Program are:
- Clinical outcomes (25%)
- Safety (25%)
- Person and community engagement (25%)
- Efficient and cost reduction (25%)
Using the Definitive Healthcare HospitalView product, we have ranked the top U.S. hospitals by their 2021 revenue adjustment. Value-based purchasing data is unavailable for fiscal year 2022 due to CMS pausing some quality reporting programs during the COVID-19 public health emergency.
| Rank | Hospital name | City | State | Definitive ID | Est FY 2021 revenue adjustment | Medicare FY 2021 VBP adjustment | Net patient revenue | Explore dataset |
|---|---|---|---|---|---|---|---|---|
| 1 | Mayo Clinic Hospital - Saint Marys Campus | Rochester | MN | 2191 | $9,541,830 | 1.69% | $3,445,394,515 | Explore |
| 2 | AdventHealth Orlando (FKA Florida Hospital Orlando) | Orlando | FL | 873 | $3,035,012 | 0.90% | $5,403,037,761 | Explore |
| 3 | Tisch Hospital | New York | NY | 2843 | $2,668,624 | 0.63% | $6,636,774,000 | Explore |
| 4 | Mayo Clinic Hospital - Arizona | Phoenix | AZ | 178 | $2,233,883 | 1.91% | $2,252,231,028 | Explore |
| 5 | St Francis Hospital & Heart Center (AKA St Francis Hospital - The Heart Center) | Roslyn | NY | 2830 | $2,165,695 | 1.18% | $889,309,434 | Explore |
| 6 | Hospital for Special Surgery | New York | NY | 2840 | $2,123,900 | 1.95% | $1,121,280,830 | Explore |
| 7 | Cleveland Clinic Main Campus | Cleveland | OH | 3120 | $1,854,175 | 0.82% | $6,378,833,101 | Explore |
| 8 | Evanston Hospital (AKA NorthShore Evanston Hospital) | Evanston | IL | 1154 | $1,513,604 | 0.94% | $1,810,357,761 | Explore |
| 9 | Oroville Hospital | Oroville | CA | 309 | $1,248,921 | 2.22% | $347,828,417 | Explore |
| 10 | Virginia Mason Medical Center | Seattle | WA | 4381 | $1,196,634 | 1.64% | $1,277,367,870 | Explore |
| 11 | Massachusetts General Hospital | Boston | MA | 1973 | $1,181,087 | 0.41% | $3,504,058,795 | Explore |
| 12 | John Muir Health - Walnut Creek Medical Center | Walnut Creek | CA | 320 | $1,110,886 | 1.00% | $1,091,934,905 | Explore |
| 13 | Rush University Medical Center | Chicago | IL | 1149 | $1,070,621 | 0.85% | $2,110,807,037 | Explore |
| 14 | FirstHealth Moore Regional Hospital | Pinehurst | NC | 3011 | $1,061,591 | 1.37% | $813,832,369 | Explore |
| 15 | Mayo Clinic Hospital - Florida | Jacksonville | FL | 792 | $1,061,192 | 1.03% | $1,088,504,655 | Explore |
| 16 | Providence St Patrick Hospital | Missoula | MT | 2475 | $1,048,518 | 1.90% | $396,834,270 | Explore |
| 17 | UNC Rex Hospital (FKA Rex Hospital) | Raleigh | NC | 3039 | $989,543 | 1.00% | $1,348,880,000 | Explore |
| 18 | Stanford Hospital - 300 Pasteur Dr | Stanford | CA | 588 | $969,715 | 0.37% | $6,216,040,779 | Explore |
| 19 | St Lukes University Hospital - Bethlehem | Bethlehem | PA | 3556 | $962,786 | 0.69% | $1,215,264,005 | Explore |
| 20 | University Hospital | Madison | WI | 4493 | $920,741 | 0.69% | $2,391,577,364 | Explore |
Fig 1. Data is from the Definitive Healthcare HospitalView product. Data is sourced from Hospital Compare and is updated quarterly. Data accessed September 2023.
Which hospitals had the highest positive revenue adjustment due to value-based purchasing?
The hospital with the highest positive revenue adjustment due to VBP was Mayo Clinic Hospital - Saint Mary’s Campus. This hospital had a 1.69% VBP adjustment with a revenue adjustment of $9.5 million.
The second top hospital by positive VBP revenue adjustment was AdventHealth Orlando. With a 0.90% VBP adjustment, this hospital had a revenue adjustment of $3 million.
In third place is Tisch Hospital. Tisch Hospital had a 0.63% VBP adjustment and a revenue adjustment of $2.7 million.
What are value-based purchasing scores?
Value-based purchasing scores track hospital performance based on four quality measures: clinical outcomes, person and community engagement, safety, and efficiency and cost reduction.
These four domains are weighted evenly and make up a hospital’s Total Performance Score (TPS). While the weightings, domains, and measures can vary each year, a hospital’s TPS drives the Medicare Value Purchasing Adjustment. A positive adjustment indicates an increase in Medicare payments, whereas a negative number indicates a decrease. This payment is based on three factors:
- Achievement points: How well a hospital performs on each of the measures compared to all hospitals’ performance during the baseline period
- Improvement points: How much it has improved on each measure compared to the baseline period
- Measure/dimension score: Represents the higher of either the achievement or improvement points
Learn more
Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Learn which U.S. states have the highest average VBP scores, or start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians, and other healthcare providers.
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