Evaluation of the Premier Hospital Quality Incentive Demonstration

The purpose of this project is to evaluate the impact of the six years of the Premier Hospital Quality Incentive Demonstration (PHQID) on the changes in the quality of hospital care, the impacts on Medicare beneficiary acute-care inpatient length of stay (LOS), and mortality for six prevalent inpatient diagnoses. Premier enrolled 250 hospitals (with 230 Medicare provider numbers) that also participated in the first three years of the demonstration. These hospitals belong to a group of over 500 hospitals that subscribe to Premier's Perspectives hospital management system. Under the first three years of the demonstration, CMS rewarded top-performing hospitals in each year of the demonstration. In addition, CMS penalized hospitals in the third year of the demonstration that performed below an absolute level of quality that was established after the first year of the demonstration. The extension includes a sixth clinical area, Surgical Care Improvement Project (SCIP). CMS also added test measures. Under the extension, CMS revised the incentive structure to reward not only top performers, but also those that attain median quality and those that improve the most. Penalties were also imposed on hospitals with low composite scores on the quality measures during the extension.