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How Do Safety-Net Hospitals Perform on Episode Spending Measures?

In a recent publication, VSSL members Dr. Joshua Liao and Lingmei Zhou partnered with Amol Navathe from the University of Pennsylvania to analyze publicly reported Clinical Episode-Based Payment (CEBP) measures at safety-net and non-safety-net hospitals.


Publicly reporting hospital spending for specific episodes of care is a promising, but relatively understudied, strategy for containing hospital spending. Dr. Liao and team analyzed 6 novel Clinical Episode-Based Payment (CEBP) measures implemented by Medicare in the Hospital Inpatient Quality Reporting program, with several key findings:

  • Among hospitals subject to CEBP measures nationwide, safety-net hospitals were larger and were more likely to be nonprofit, nonteaching hospitals than non–safety-net hospitals.

  • The magnitude of episode spending varied by episode type, ranging from the lowest for cellulitis episodes to the highest for aortic aneurysm episodes.

  • Episode spending was not associated with hospital safety-net status for any episode type.

The study findings provided the first description of baseline episode spending patterns for safety-net hospitals and suggest that such spending does not vary by safety-net status.


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