This project has three primary purposes:

• To estimate the impact on rural hospitals in the U.S. of a pay-for-performance (PFP) program similar to the CMS-sponsored Premier, Inc. Hospital Quality Incentive Demonstration
• To complete a synthesis of the major factors that will influence the inclusion of rural hospitals in PFP programs
• To make recommendations for the design of PFP programs that will appropriately reward rural hospitals for improving quality.

This project will empirically assess how rural hospitals in the U.S. would fare financially (i.e., receive bonus payments, be eligible for reduced DRG payments) if they participated in the CMS-sponsored Premier Hospital Quality Incentive Demonstration (HQID); identify and thoroughly examine the key factors that facilitate or constrain rural hospital participation in pay for performance programs; and describe options for the design of pay for performance programs that are relevant for rural hospitals that seek quality improvement. This study will use data from several sources, including data on the CMS 7th Scope of Work measures and data from a telephone survey of key representatives from major stakeholders (e.g., CMS, Premier, AHA, rural hospitals, rural relevant physician associations) involved with pay-for-performance projects.

Publications

• Does Hospital Size Affect Our Ability to Accurately Identify High Quality Care in Pay-for-Performance Programs?
  Upper Midwest Rural Health Research Center
  Date: 05/2007
  This policy brief discusses whether hospital size impacts the ability to identify hospitals' performance in a pay-for-performance demonstration project based on hospital rankings.
• Hospital Size, Uncertainty and Pay-for-Performance
  Upper Midwest Rural Health Research Center
  Date: 02/2007
  This report examines whether hospital size impacts the ability to identify hospitals' performance in a pay-for-performance demonstration project based on hospital rankings.
• Implementation of Pay-for-Performance in Rural Hospitals: Lessons From the Hospital Quality Incentive Demonstration Project
  Policy Brief
  Upper Midwest Rural Health Research Center
  Date: 11/2006
  This paper provides an overview of findings of a national study to identify institutional, organizational, and environmental factors that influence the experience of rural hospitals in the Hospital Quality Incentive Demonstration project.
• Implementation of Pay-for-Performance in Rural Hospitals: Lessons From the Hospital Quality Incentive Demonstration Project (Full Report)
  Upper Midwest Rural Health Research Center
  Date: 09/2006
  This report shares the findings of a national study designed to identify institutional, organizational, and environmental factors that influence the experience of rural hospitals in the Hospital Quality Incentive Demonstration Project.