The facility has gone from being among the top 20% in two conditions during the first year to being on track to hitting that mark for four conditions in the upcoming year, said Dr. Povroznik. The payout has been tiny, with an estimated $143,000 in bonuses due for 2007, but the rewards are large in quality improvement, he said.
For instance, the hospital was struggling to meet a “door-to-balloon” time for acute myocardial infarction. Initially, the hospital was hitting a 2-hour mark for only 71% of cases. Now, 100% of eligible cases are given angioplasty within a recommended 90-minute target, Dr. Povroznik said.
The demonstration project has proved that incentives can work, said Dr. Wynn. CMS is tinkering slightly with the project, however. Starting this year, there will be incentives not just for improvement over baseline and for hitting the top 20%, but also for hospitals that show the greatest improvement. A total of $12 million will be available, he said.