Do Magnet®-Designated Hospitals Perform Better on Medicare's Value-Based Purchasing Program?

Abstract

OBJECTIVE The aim of this study was to explore the relationship between a hospital's Magnet® recognition status, tenure, and its performance in the Hospital Value-Based Purchasing (HVBP) program. BACKGROUND Previous studies have sought to determine associations between quality of care provided in inpatient setting and the Magnet Recognition Program®; however, no study has done so using the most recent (FY2017) iteration of the HVBP program, nor determined the influence a hospital's Magnet designation tenure has on HVBP scores. METHOD This study used a cross-sectional study design of 2686 hospitals using propensity score matching to reduce bias and improve comparability. RESULTS Magnet-designated hospitals were associated with higher total performance, process of care and patient experience of care scores, and lower efficiency score. No association was identified between the length of time hospitals have been Magnet designated. CONCLUSION Findings suggest non-Magnet status hospitals need to consider implementing the principles of Magnet into their culture or participation in the Magnet Recognition Program to provide higher quality of care.

The influence of community health on hospitals attainment of Magnet designation: Implications for policy and practice

“…While the predominant focus in empirical research on determinants of access to care has been on individual‐level factors, our results offer a broader view of the influencers in the county environment associated with the presence of Magnet‐designated facilities, independent of organizational variables. Our work supports the findings of previous cross‐sectional studies identifying the clinical benefits of Magnet designation (Hamadi et al, 2020; Spaulding et al, 2020), and extends it towards understanding how county‐level factors affect access to and quality of health care. As conceived by Penchansky and Thomas (1981), access to a health facility, such as a Magnet hospital, is closely tied to its availability and affordability and reflects the fit between the health system's characteristics and expectations of the recipients.…”

“…Historically, larger and better‐resourced hospitals have had greater success in achieving Magnet designation due to the organizational size and having more financial resources, diverse facilities and better scale economies for raising capital (Damanpour & Schneider, 2006). More specially, non‐profit status, larger hospitals, teaching affiliation and higher RN staffing rates have been tied to Magnet attainment (De Cordova et al, 2020; Spaulding et al, 2020). However, while previous inquiry has sought to determine the relationship of Magnet status with surrounding communities, studies have failed to clearly account for the social determinants of health.…”

The role of community‐level characteristics in comparing United States hospital performance by magnet designation: A propensity score matched study

“…A difference of 7.15% in clinical care scores certainly would affect the performance scores of organizations serving vulnerable communities. Previous research aligns with this study's finding that magnet hospitals score better on the HVBP Clinical Care domains (Friese et al, 2015; Spaulding et al, 2020) despite the lack of adjustment for characteristics of the surrounding communities. The basic tenets of magnet designation empower nurses, making it easier to attract and maintain nursing staff (Needleman & Hassmiller, 2009) who play a central role in clinical and communication processes.…”

“…A difference of 7.15% in clinical care scores certainly would affect the performance scores of organizations serving vulnerable communities. Previous research aligns with this study's finding that magnet hospitals score better on the HVBP Clinical Care domains (Friese et al, 2015;Spaulding et al, 2020) et al, 2022). However, while this would logically promote the idea that magnet hospitals benefit from caring for patients with better access to care and who have better SES, the results of this study suggest that magnet hospitals perform better even when matched against non-magnet hospitals with similar communitylevel characteristics.…”

“…The domains measured for the Total Performance Score (TPS) for the IPPS, and their respective weightings, have changed since its inception in 2013 (Harrison et al, 2017) and currently include four key areas: Clinical Care, Person and Community Engagement, Safety, and Efficiency and Cost Reduction (Centers for Medicaid and Medicare Services, 2021b). This national shift from ‘fee for service’ to ‘fee for value’ has been widely studied (Hong et al, 2020) to identify organizational characteristics, including magnet designation (Lasater, 2017; Spaulding et al, 2020), that are predictive of hospitals' differential success in the HVBP program. However, the effects of these community characteristics on magnet designated hospital performance and quality measures have largely been ignored.…”