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Adding a spending per beneficiary measure to the Hospital Value-Based Purchasing Program in 2015 while decreasing the weight of the quality measures allowed some lower quality hospitals to receive bonuses, according to  published this week in Health Affairs. “High-quality low-spending hospitals received the greatest financial benefit from the program,” the authors note. “In this respect, [the Centers for Medicare & Medicaid Services’] achieved its goal with the new spending measure.” However, they said hospital quality “had a weak and inconsistent association with spending,” and suggested CMS consider incorporating a minimum quality threshold into the program.