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EXECUTIVE SUMMARY: Medicare's Hospital Valued-Based Purchasing (HVBP) program measures hospitals' total performance score (TPS); its measurement strategies have changed regularly since its rollout in 2013. Because the program influences care delivery, it is important to examine how the policy has changed hospitals' behavior and how it may inform future policies. The purpose of this study was to assess the relationship between hospitals' performance on TPS annually from 2013 to 2018 and organizational characteristics. Using the HVBP TPS from 2013 to 2018 and associated hospital characteristics—hospital size, teaching hospital status, system membership, ownership type, urban/rural location, average percentages of patients from Medicare and Medicaid, operating margins, percentages of inpatient revenue as a proportion of total revenue, and case mix index—we conducted a retrospective cohort study of all U.S. hospitals participating in the HVBP program. Regression and panel analyses found that organizations that were expected to have robust and rigid resources were unable to score in the superior category consistently. In addition, organizations were unable to consistently perform positively over time because of changes in the HVBP program measurement and the required organizational responses. Policymakers should consider the ability of organizations to respond to changes to the HVBP program. Likewise, healthcare managers, particularly those in larger organizations, should seek to remove bureaucracy or allow for greater resource slack to meet these changes. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective cross-sectional study.Objectives: The aim of this study was to examine whether there are racial and ethnic disparities in opioid use for back pain treatment. In addition, we examine whether physical therapy reduces opioid use.Summary Of Background Data: Back pain is a common health problem that affects most adults in their lifetime. Opioid and physical therapy are commonly used to treat back pain. While evidence indicates that there are substantial disparities in the receipt of opioids by race and ethnicity in opioid use in the United States, it remains unclear whether these disparities in opioid use exist in the treatment of back pain.Methods: Cross-sectional analysis of the 2010-2012 Medical Expenditures Panel Survey and logistic regression of a sample of about 4,000 adults with back pain.Results: Logistic regression models showed statistically significant differences in opioids receipt by race among adult patients with back pain. Compared to White patients, Asian and Hispanic patients are less likely to be prescribed opioids. On the other hand, Black patients and patients of other race are more likely to receive an opioid prescription to treat their back pain even after accounting for socioeconomic status, health insurance status, and general health status. Additionally, patients who receive physical therapy treatment are less likely to be prescribed opioids.Conclusions: These findings suggest that there are racial disparities in the use of opioids and physical therapy may reduce opioid prescription use to treat back pain. These disparities may be contributing to disparities in back pain recovery and long-term health disparities in general.Level Of Evidence: 2. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to explore the relationship between a hospital's Magnet® recognition status, tenure, and its performance in the Hospital Value-Based Purchasing (HVBP) program. BACKGROUND: Previous studies have sought to determine associations between quality of care provided in inpatient setting and the Magnet Recognition Program0 ; however, no study has done so using the most recent (FY2017) iteration of the HVBP program, nor determined the influence a hospital's Magnet designation tenure has on HVBP scores. METHOD: This study used a cross-sectional study design of 2686 hospitals using propensity score matching to reduce bias and improve comparability. RESULTS: Magnet-designated hospitals were associated with higher total performance, process of care and patient experience of care scores, and lower efficiency score. No association was identified between the length of time hospitals have been Magnet designated. CONCLUSION: Findings suggest non-Magnet status hospitals need to consider implementing the principles of Magnet into their culture or participation in the Magnet Recognition Program to provide higher quality of care. [ABSTRACT FROM AUTHOR]