A study published in the Archives of Internal Medicine suggests CMS’s Hospital Value-based Purchasing program could mean trouble for safety net hospitals, because safety net hospitals tend to get poorer marks from patients than do other hospitals. These patient satisfaction scores will be used to dole out bonuses and penalties beginning in October.

However, according to the iVantage report, “Rural Relevance Under Healthcare Reform,” rural hospital performance on HCAHPS patient experience survey measures is better than urban hospitals. The iVantage report was released in April, and updated last month. You can read the updated report here.