Here’s the
thing: I might just be the only who does.
A March 2012 Health Affairs study found that “Medicare’s
seven-year public reporting initiative for hospitals, Hospital Compare, had no
impact on reducing death rates for two key health conditions and just a modest
effect on a third. [This] raises questions about the initiative’s ability to
improve the quality of care provided by the nation’s hospitals.”
Whaaat? All this effort, all this reporting, and no
one’s using the data. I think I’m having
a heart attack (and there’s no time to check the website!) The study also notes that when Hospital
Compare was rolled out in 2005, “there was no comparable control group of
hospitals that were not exposed to the program.
Thus, even if mortality has declined since the introduction of this program,
it could be that these improvements were the result of other innovations in
clinical care that fueled secular trends toward better outcomes in general, and
not the program itself.” Indeed,
clinical outcomes for risk-adjusted mortality rates declined during the time
period for which the study was conducted, but only continued to follow
pre-existing trends:
In
addition, “past surveys have suggested that quality report cards like Hospital
Compare are underused by patients and ignored by referring physicians. This
study adds to that evidence suggesting that consumers at least did not seem to
be checking the Medicare website to make more informed choices about where to
check in for an elective procedure.”
It is unclear to me whether this is simply a lack of awareness, or
checking a website with published readmission rates and measures indicating
whether a beta blocker was appropriately provided really helps the consumer at
all. I recently used Yelp to find my
PCP, and found it to be incredibly helpful to hear user reviews. Maybe, at the end of the day, people want to
hear what their friends and family, not what CMS, has to say about hospitals.
Regardless
of the study’s findings, the website exists, and hospital quality departments
are not going away any time soon.
Indeed, they have played a key role in helping to attain Joint
Commission accreditation, implementing quality initiatives, and of course,
publicly reporting quality data. But
could they be doing more? Given the challenging
environment hospitals are faced with and will continue to face in the next 5-10
years, why not use something that is already required to your advantage, as much as possible? For instance, they could…
1)
Brag about it: If you’re outperforming other hospitals in your region on certain
metrics, especially those related to patient satisfaction, market that! People like things that other people
like. Show this off.
2)
Bring it to payer negotiations: Tell health insurers why you should be the provider of choice, what
you’ve done to improve quality of care, and why patients want you in their
networks.
3)
Use it to attract the best workforce: The Health Affairs study found that quality metrics had no effect on
referrals. But maybe physicians should
start caring – and the hospital can play a role in this. Why wouldn’t a physician want to come and
practice medicine at a place that has solid processes in place to achieve best-in-class
patient safety metrics? Or where
patients are happy with the facilities and nursing staff? And clinicians are not limited to physicians. Nurses, physician extenders and
administrative staff might be attracted to a place that scores well on process
and outcomes metrics.
Would
love to hear your thoughts. Is it not a
shame that there is so much data not
being used to its full potential?
