This CMS database study suggests that hospitals that can reduce postdischarge spending may perform better on CMS' new spending measure.

The Centers for Medicare & Medicaid Services (CMS) is incentivizing hospitals to provide high-quality, low-cost care. As part of these efforts, CMS recently added the Medicare Spending per Beneficiary (MSPB) metric to its Hospital Value-Based Purchasing (HVBP) program, marking the first time that most US hospitals have received financial penalties or rewards based on their performance on a risk-adjusted, price-standardized 30-day episode-based measure of Medicare spending along with quality measures. The factors that influence or determine hospital performance in this metric have not yet been thoroughly investigated. We evaluated whether hospital performance was driven by spending before, during, or after hospitalization.