Do Performance Measures Accurately Rank Hospitals?

Hospital performance on quality metrics affects financial incentives through the U.S. Centers for Medicare & Medicaid Services' (CMS) value-based programs, and such performance often is incorporated into public reporting and hospital rankings. Currently, hospital metrics used in these CMS value-based programs consider data from only Medicare fee-for-service (FFS) patients and exclude patients with Medicare Advantage (MA) plans — a large and growing proportion of patients. Notably, MA patients are, on average, older than FFS patients and are more likely to be from minority groups (Hispanic and non-Hispanic Black).

Using cross-sectional data from >2000 U.S. hospitals and >1.5 million patients, investigators assessed how hospital mortality and …