Quality Care. Financial Gains. How Performance Powers Financial Opportunity

In healthcare today, quality isn’t just a clinical benchmark—it’s a powerful financial strategy. The connection is clear: higher-quality care drives stronger financial performance, creating a self-sustaining cycle of growth.

The Proof: Quality Drives Financial Wins

• • A 3.4% increase in net Medicare patient revenue per discharge is linked to just a one-star gain in CMS ratings. (Kuranz et al.)
  • Hospitals with higher CMS ratings command higher prices, suggesting stronger leverage in payer negotiations (RAND Corporation)
  • Increases in Case Mix Index (CMI) correlate with higher total payments, highlighting the importance of accurate acuity capture. (Clinical Intelligence)

A Higher Quality Score Means Bigger Gains

A higher quality score doesn’t just improve patient outcomes—it also brings:

• • Stronger payer negotiation power and higher reimbursements
  • Increased patient volumes, including more elective procedures
  • Fewer avoidable costs and higher margins
  • Bonus opportunities, such as value-based program incentives
  • Stronger market positioning and preferred network status
  • Ability to attract and retain top clinical talent
  • More philanthropic and grant funding support

On the other hand, lower quality scores can lead to financial penalties and lost revenue, creating a drag on performance that is hard to overcome.

The Quality/Finance Cycle

Better clinical performance improves ratings, which boosts financial outcomes through higher reimbursements and patient volumes. These gains enable reinvestment in care delivery, innovation, and talent—fueling further improvement.

How Tendo Helps

At Tendo, our Insights platform empowers health systems to measure, monitor, and improve performance so they can achieve the quality ratings they deserve. That means better outcomes for patients and a healthier bottom line.