The Hospital Value-Based Purchasing Program did not result in meaningful improvements in clinical process or patient experience measures during its first four years, because performance improved similarly for hospitals not exposed to the program, according to a study reported last week in the New England Journal of Medicine. The program was associated with reduced mortality among patients admitted for pneumonia, but not among patients admitted for heart attack or heart failure. Nancy Foster, AHA vice president for quality and patient safety policy, said the findings “should not be surprising for two important reasons. First, the measures used in the VBP program, especially those used in the first few years, had been publicly reported for several years. Many of the improvements that could be achieved had already occurred. Second, hospitals view the inclusion of a measure in the Hospital VBP program as a strong signal from Medicare that high performance on the measure is important. Thus, hospitals seek to achieve high levels of performance on the chosen measures regardless of whether they are subject to a payment penalty or not.”