Table 2.

Comparison of “CMS all-cause” vs. “CMS modified-for-preventability” hospital profiles for payment adjustment under CMS pay-for-performance

		CMS modified-for-preventability model
		Better in all condition cohorts	Worse in 1 condition	Worse in 2 conditions	Worse in 3 conditions	Total
CMS all-cause model	Better in all conditions	29	5	0	0	34
	Worse in 1 condition	5	24	8	1	38
	Worse in 2 conditions	1	9	28	4	42
	Worse in 3 conditions	0	1	5	11	17
	Total	35	39	41	16	131

NOTES:

CMS= Centers for Medicare and Medicaid Services

The three condition cohorts for readmissions are acute myocardial infarction, heart failure, and pneumonia.

We combined information on predicted-to-expected readmission ratios across the 3 conditions. Not every condition included CMS readmission rates for all 131 hospitals (if volume was under 25, the hospital was not included in the analysis). If a hospital did not have a CMS-generated readmission rate, we considered the hospital profile to be “average.”