HealthLawProf Blog

Editor: Katharine Van Tassel
Creighton University School of Law

Thursday, February 24, 2011

Naughty or Nice? Quality-Based Reimbursement in Action

Maryland seems to be ahead of PPACA on some quality improvement fronts. The state's Health Services Cost Review Commission operates under a CMS waiver and exclusively sets rates for Maryland hospitals. The Commission uses quality-related measures across three initiatives, Process Measures, Complications, and Readmissions, as described here. The Commission tracks 49 "complications" such as bed sores, infections, and falls (see here). According to an article in today's Washington Post by Julie Appleby of Kaiser Health News, available here, the program seems to have real teeth. Recently, nine hospitals have been denied $2.1m in reimbursement while twenty-three will receive small bonuses. [NPT]

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