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Hospitals’ performance on most quality measures was improving before the Hospital Value-Based Purchasing program began in October 2012 and did not noticeably change during the first two years of the VBP Program, according to a new  by the Government Accountability Office. “While the HVBP program aims to provide an incentive to improve hospitals’ quality of care, preliminary analysis of information from 2013 and 2014…shows that it did not noticeably alter the existing trends in hospitals’ performance on any of the quality measures used to determine HVBP payment adjustments that we examined,” GAO said. Most of the roughly 3,000 inpatient prospective payment system hospitals eligible for the VBP program received a bonus or penalty of less than 0.5% of applicable Medicare payments in each of the first three years of the program, GAO said. Safety net hospitals consistently had lower median payment adjustments – that is, smaller bonuses or larger penalties – than hospitals overall in the first three years of the program, GAO said, although the gap narrowed over time. Small urban hospitals had higher median payment adjustments each year than hospitals overall, and small rural hospitals’ median payment adjustments were similar to hospitals overall in the first two years and higher in the most recent year. The agency was required to issue the interim report to Congress by Oct. 1 under the Affordable Care Act, and must issue a final report by July 1, 2017.