Author Affiliations: Departments of Health Policy and Management (Ms Chatterjee and Drs Joynt and Jha), Harvard School of Public Health, Boston, Massachusetts; Divisions of Cardiovascular (Dr Joynt) and General Internal Medicine (Dr Jha), Brigham and Women's Hospital, Boston; VA Boston Healthcare System, Boston (Drs Joynt and Jha); and Divisions of Cardiovascular Medicine (Dr Joynt) and General Internal Medicine (Dr Jha), Harvard Medical School, Boston. Ms Chatterjee is a medical student at Harvard Medical School.
We are grateful for the thoughtful response by Blum et al to our study and agree that improving patient experience in safety-net hospitals (SNHs) continues to be an important policy goal.
As Blum et al note, achievement, improvement, and consistency on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores are all components of the value-based purchasing (VBP) payment scheme. We addressed each of these components in our analyses, as demonstrated in our article by Table 2, Figure 1, and Table 4, respectively.1 The analysis of VBP performance by Blum et al differs slightly from ours, primarily in how SNHs are defined. Given that there is no universal agreement for how best to identify these hospitals, varying approaches will lead to somewhat different results.2
Chatterjee P, Joynt KE, Jha AK. Safety-Net Hospitals: Other Hospitals Score Similarly on Patient Experience—Reply. JAMA Intern Med. 2013;173(5):389–391. doi:10.1001/jamainternmed.2013.2670
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