MA H2461

Creates a hospital efficiency index to measure performance on low-value care, avoidable admissions, readmissions, preventable errors, hospital-acquired infections, and unnecessary length of stay

Compares hospital payment levels to quality performance and examines cost of care delivery against other hospitals, Medicare rates, and national trends

Measures administrative waste including redundant staffing, duplicative testing, and lack of electronic medical record interoperability

Requires public hearings with 45 days notice before publishing the index, with biennial reviews and annual performance reports for individual hospitals and aggregate data

Enforcement recommendations due by July 1, 2026 include requiring insurers to apply efficiency adjustments to contracts, mandating corrective action plans for poor performers, and prohibiting payment for low-value care while protecting consumers from balance billing