(NPN) – South Dakota’s hospital wereslightly above the national average for being penalized on Medicare billings, according to a study released earlier this month by Kaiser Health News and National Public Radio.Nationally, 53 percent of hospitals were penalized under Medicare’s quality incentive program. In South Dakota, 55 percent of the state’s hospitals were penalized or 6 of 11 hospitals.South Dakota also ranked below the bonus rate of 45 percent nationally, with only 36 percent or 4 hospitals received bonuses from Medicare.

However, S.D. was below the national penalty average of -0.26 percent at -0.14 percent and above the national bonus rate of 0.24 percent at 0.37 percent.

According to the study, the bonuses and penalties are one piece of the health care law’s efforts to create financial incentives for doctors and hospitals to provide better care. 2013 is the second year of the program.

In the Northern Plains region, 88 percent of Wyoming’s hospitals were penalized, while 63 percent of Nebraska hospitals received bonuses.