Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures

Abstract

It is well-established that hospitals recognized for good nursing care – Magnet hospitals – are associated with better patient outcomes. Less is known about how Magnet hospitals compare to non-Magnets on quality measures linked to Medicare reimbursement. The purpose of this study was to determine how Magnet hospitals perform compared to matched non-Magnet hospitals on Hospital Value Based Purchasing (VBP) measures. A cross-sectional analysis of three linked data sources was performed. The sample included 3,021 non-federal acute care hospitals participating in the VBP program (323 Magnets; 2,698 non-Magnets). Propensity score matching was used to match Magnet and non-Magnet hospitals with similar hospital characteristics. After matching, linear and logistic regression models were used to examine the relationship between Magnet status and VBP performance. After matching and adjusting for hospital characteristics, Magnet recognition predicted higher scores on Total Performance (Regression Coefficient [RC] = 1.66, p < 0.05), Clinical Processes (RC = 3.85; p < 0.01), and Patient Experience (RC = 6.33; p < 0.001). The relationships between Magnet recognition and the Outcome and Efficiency domains were not statistically significant. Magnet hospitals known for nursing excellence perform better on Hospital VBP measures. As healthcare systems adapt to evolving incentives that reward value, attention to nurses at the front lines may be central to ensuring high-value care for patients.