Would you buy a car, hire a repairman, order something from amazon.com or even rent a movie without first checking the online rating? Not likely. Today, we count on ratings and reviews to decide
how to get the best value for our money. Shopping for a doctor or hospital is no different.
The Centers for Medicare and Medicaid Services has mandated that health care providers and suppliers increase transparency regarding the quality and cost of health care. Why? CMS believes that such transparency will motivate health care providers to give higher-quality, more cost-effective care.
In this new era of health care transparency, there are multiple ways patients can review data about outcomes, health care costs and patient satisfaction. The CMS posts information on its site about the cost and quality of care Medicare and Medicaid patients receive. In addition, third-party companies such as The Leapfrog Group and Consumer Reports post ratings using data they purchase from health care organizations. UF Health also posts data.
“We want our patients to have as much information as possible to make informed choices,” said Randy Harmatz, chief quality officer for UF Health. “We welcome transparency. Our goal is to be the best health care system in the world. And we want the world to know.”
In this issue of The Q Report, we will review how and where patients can learn more about UF Health’s data and how these sources differ.
The Centers for Medicare and Medicaid Services posts information about the cost and quality of care. To ensure that scores are fair, all hospitals are judged by the same set of rules. Risk adjustment is used to level the playing field for hospitals that care for sicker patients. For example, because UF Health Shands Hospital is a quaternary care hospital, extremely sick patients with complex conditions are often transferred here for advanced specialty care.
“Anyone who is sick enough to leave one hospital for another is probably sicker than the average person who drives their own car to the hospital,” said Millie Russin, M.S.N., R.N., director of quality analytics in the UF Health Sebastion Ferrero Office of Clinical Quality and Patient Safety. “So the risk models adjust for that.”
CMS posts information about:
• Adherence to best practices
• Complication rates
• Infection rates
• Readmission rates
• Mortality rates
• Patient satisfaction
• Cost of care for Medicare patients
• Use of radiology tests
CMS intends for its website to serve as the go-to place for consumers to check when deciding where to get health care. Right now there are tables with comparative numbers and graphs. To make the website more consumer-friendly CMS will soon introduce star
ratings — with five stars being the best.
Agency for Health Care Administration
Another site where patients can find health care data is Florida’s Agency for Health Care Administration. This site allows consumers not only to compare hospitals, facilities and providers but also to review health care plans.
In addition, the site reports quality measures, including:
• Complication and infection rates
• Mortality rates
• Readmission rates
• Pediatric measures
Several companies buy summary data about hospitals from the government. They apply their own rating system and award stars, letter grades (A through F), or
color-coded circles to help consumers and insurers decide the best places to get health care. Examples include The Leapfrog Group, Healthgrades and Consumer Reports. Some of these sites are free and others require a subscription.
The data comes from information on hospital bills, patient surveys on hospital experiences and chart abstraction. Now that the hospital system has electronic health records, data are increasingly being mined from designated fields in the chart. Everyone who enters information in the chart can help ensure the data is accurate.