Healthcare Insights

Top 20 Hospitals in Value-Based Purchasing

The Centers for Medicare & Medicaid Services (CMS) launched the Value-Based Purchasing (VBP) Program in 2013 to reward hospitals that provided high-quality care.

Under the Value-Based Purchasing Program, hospitals are eligible for an increase or decrease in their Inpatient Prospective Payment System rate, a model that determines Medicare reimbursement for each hospital based on the quality of care provided.

In fiscal year 2019, the payments are supported through a 2 percent reduction of Diagnosis-Related Group fund­ing for all hospitals, which in turn is distributed between eligible facilities according to performance.

The performance measurement domains for the 2019 Hospital Value-Based Purchasing Program are:

  • Clinical Care
  • Safety
  • Person and Community Engagement
  • Efficiency and Cost Reduction

For the year, the total amount of available funds is approximately $1.9 billion.

Overall, about 56 percent of hospitals received positive adjustments in 2019.

Of those receiving bonuses, the average adjustment rate was 0.61 percent, with an average estimated increase in revenue of about $124,354. Hospitals with high positive adjustment rates tended to be smaller, and the majority of facilities earning rates over 1 percent had less than 100 beds.

The highest estimated revenue earners had modest rate increases, though their larger size translated to greater bonus payments overall.

Among penalized hospitals, the average adjustment was -0.39 percent, with an average estimated revenue de­crease of nearly $156,256. Compared to hospitals with positive rate adjustments, the facilities were usually larger, averaging 255 staffed beds versus 173.

Top 20 Hospitals by Value-Based Purchasing

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 Hospital NameDefinitive IDEstimated 2019 Revenue AdjustmentMedicare FY 2019 AdjustmentNet Patient RevenueStaffed BedsExplore This Dataset
1.Mayo Clinic Hospital - Saint Marys Campus (MN)2191$3,578,546 1.08%$2,584,637,894 1,115Explore This Profile
2.AdventHealth Orlando (FL)873$2,589,745 0.75%$3,769,768,374 2,753Explore This Profile
3.Mayo Clinic Hospital - Arizona (AZ)178$1,551,755 1.38%$1,392,149,121 269Explore This Profile
4.Massachusetts General Hospital (MA)1973$1,257,414 0.45%$2,903,757,623 987Explore This Profile
5.Cleveland Clinic Main Campus (OH)3120$1,186,206 0.54%$5,164,424,360 1,285Explore This Profile
6.St Cloud Hospital (MN)2223$1,185,926 0.81%$852,750,902 451Explore This Profile
7.UAB Hospital (AL)71$1,117,317 0.77%$1,548,385,737 1,063Explore This Profile
8.FirstHealth Moore Regional Hospital (NC)3011$1,095,849 1.05%$627,661,607 412Explore This Profile
9.Piedmont Atlanta Hospital (GA)998$1,065,764 0.93%$946,187,728 488Explore This Profile
10.UCSF Helen Diller Medical Center at Parnassus Heights (CA)560$1,041,401 0.54%$3,620,962,130 782Explore This Profile
11.Cedars-Sinai Medical Center (CA)430$1,036,631 0.33%$3,140,742,831 880Explore This Profile
12.Ascension Providence Hospital - Southfield Campus (MI)2062$996,418 0.87%$572,753,485 582Explore This Profile
13.Munson Medical Center (MI)2018$992,667 1.06%$591,056,215 409Explore This Profile
14.UNC Rex Hospital (NC)3039$942,976 0.81%$1,060,817,400 439Explore This Profile
15.Mercy Hospital (MN)2119$910,844 0.82%$724,833,736 466Explore This Profile
16.Northwestern Memorial Hospital (IL)1135$876,244 0.54%$1,745,967,766 883Explore This Profile
17.Northeast Georgia Medical Center (GA)1010$854,047 0.71%$1,266,568,544 545Explore This Profile
18.Providence St Patrick Hospital (MT)2475$853,884 1.64%$352,654,628 158Explore This Profile
19.Baylor Scott & White Medical Center-Temple (TX)3849$808,846 0.58%$1,335,881,066 640Explore This Profile
20.The University of Kansas Hospital (KS)1631$797,571 0.60%$1,975,125,402 831Explore This Profile

Fig 1. Data from Definitive Healthcare, Revenue adjustment is estimated 2019 data; Net patient revenue and staffed beds is 2018 data. Based on most recent CMS data update.

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