Healthcare Insights
Top 20 hospitals in value-based purchasing
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.
The Hospital VBP Program rewards hospitals that provide high-quality care to Medicare patients. Under the program, 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.
The performance measurement domains for the 2021 Hospital VBP Program are:
- Clinical Outcomes (25%)
- Safety (25%)
- Person and Community Engagement (25%)
- Efficiency and Cost Reduction (25%)
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.
Top 20 hospitals by revenue adjustment due to value-based purchasing adjustment
| Rank | Hospital name | Definitive ID | Est FY 2021 revenue adjustment | Medicare FY 2021 VBP adjustment | Net patient revenue | Staffed beds | Explore dataset |
|---|---|---|---|---|---|---|---|
| 1 | Mayo Clinic Hospital - Saint Marys Campus (MN) | 2191 | $5,236,286 | 1.69% | $3,317,828,896 | 1,143 | Explore |
| 2 | AdventHealth Orlando (FL) | 873 | $3,200,929 | 0.90% | $5,004,081,001 | 2,247 | Explore |
| 3 | Hospital for Special Surgery (NY) | 2840 | $2,378,354 | 1.95% | $1,026,986,404 | 205 | Explore |
| 4 | Mayo Clinic Hospital – Arizona (AZ) | 178 | $2,292,448 | 1.91% | $2,066,052,128 | 302 | Explore |
| 5 | St Francis Hospital & Heart Center (NY) | 2830 | $2,110,018 | 1.18% | $884,418,262 | 364 | Explore |
| 6 | Cleveland Clinic Main Campus (OH) | 3120 | $1,970,337 | 0.82% | $6,037,196,525 | 1,326 | Explore |
| 7 | Tisch Hospital (NY) | 2843 | $1,961,907 | 0.63% | $6,273,707,636 | 725 | Explore |
| 8 | Evanston Hospital (IL) | 1154 | $1,792,858 | 0.94% | $1,730,812,209 | 354 | Explore |
| 9 | Oroville Hospital (CA) | 309 | $1,495,204 | 2.22% | $347,274,293 | 153 | Explore |
| 10 | FirstHealth Moore Regional Hospital (NC) | 3011 | $1,480,053 | 1.37% | $777,631,182 | 412 | Explore |
| 11 | Virginia Mason Seattle Medical Center (WA) | 4381 | $1,348,702 | 1.64% | $1,166,266,808 | 231 | Explore |
| 12 | Massachusetts General Hospital (MA) | 1973 | $1,237,804 | 0.41% | $3,376,488,407 | 995 | Explore |
| 13 | Rush University Medical Center (IL) | 1149 | $1,215,931 | 0.85% | $1,992,372,740 | 592 | Explore |
| 14 | Providence St Patrick Hospital (MT) | 2475 | $1,199,687 | 1.90% | $385,409,968 | 209 | Explore |
| 15 | UNC Rex Hospital ((NC) | 3039 | $1,194,304 | 1.00% | $1,216,062,000 | 439 | Explore |
| 16 | John Muir Health - Walnut Creek Medical Center (CA) | 320 | $1,103,312 | 1.00% | $1,082,908,598 | 506 | Explore |
| 17 | University Hospital (WI) | 4493 | $1,082,060 | 0.69% | $2,324,088,319 | 606 | Explore |
| 18 | Mercy Hospital (MN) | 2119 | $1,047,689 | 1.11% | $763,638,199 | 461 | Explore |
| 19 | Munson Medical Center (MI) | 2018 | $1,002,779 | 1.13% | $669,547,434 | 399 | Explore |
| 20 | Mayo Clinic Hospital – Florida (FL) | 2119 | $992,203 | 1.03% | $986,907,022 | 304 | Explore |
Fig 1. Data is from the Definitive Healthcare HospitalView product. Revenue adjustment is estimated 2021 data. Net patient revenue and staffed beds are 2020 data. Based on the most recent CMS data update.
Which hospitals had the highest positive revenue adjustment due to VBP?
Overall, more than half of hospitals received positive adjustments in fiscal year 2021. For hospitals receiving bonuses, the average adjustment rate was 0.69%, with an average estimated increase in revenue of about $155,015.
Hospitals with high positive adjustment rates tended to be smaller. Most facilities that earned rates over 1% had fewer than 70 beds.
Among penalized hospitals, the average adjustment was -0.45%, with an average estimated revenue decrease of nearly $191,992. Compared to hospitals with positive rate adjustments, the facilities were usually larger, averaging 265 staffed beds compared with 176.
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