What should policymakers do now? Jha was asked.
"In some ways we have to go back to the drawing board," he says. "I'm a big believer in pay for performance, despite this study. But I think we need to figure out the 'pay' part, and the 'performance part. I actually think 1% is not enough. It should be more substantial."
He was referring to the fact that under value-based purchasing rules set forth by the Affordable Care Act, all hospitals in nation this year will receive only 99% of their Medicare base DRG starting Oct. 1. That 1% goes into a pool that is redistributed to hospitals with the best value-based purchasing scores based on 12 process of care measures (70%) and patient responses to patient experience surveys (30%) during a measurement period that began July 1, 2011.
Hospitals with the lowest scores will not earn any of their 1% back.
Jha also thinks value-based purchasing should be re-worked with more emphasis on outcome measures, and that is starting to happen.
Next year, the value-based purchasing formula will introduce a measure for 30-day mortality, the first outcome measure in the rule.
When the six-year project ended last November, Premier said that participating hospitals had "saved an estimated 8,500 heart attack patients" and administered more than 960,000 additional evidence based measures to 2.7 million patients" cared for at those hospitals.