Public quality reporting: It shouldn’t be so hard

March 18th, 2015

Now that we’re in the midst of what I like to call hospital award season – that time of year when my inbox overflows with press releases from facilities touting their appearance on one of the myriad “best hospitals” lists out there – maybe it’s worth taking a moment to reconsider the point of all this ranking and reporting.

In my opinion at least, it should be about two things:

• Giving consumers good, comprehensible data that they can use to make informed decisions about their healthcare.
• Pressuring hospitals to either keep up the good work or to shape up quickly if they want to compete.

Frankly, I don’t think either of those goals is being met. Even a motivated, intelligent healthcare consumer could find him- or herself bewildered by the sheer number of hospital ratings, rankings and grading systems – not to mention by their varying criteria.

Just last month, Health Services Research published a study that concluded, “Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider,” according to the study’s abstract. That study was specifically about data provided by the federal government’s Hospital Compare site.

I’ve mentioned before my hope that Hospital Compare could eventually live up to its name and fully meet the goals I listed above – but I have to admit that my hope is waning. Currently at least, the site doesn’t provide enough information to be considered truly comprehensive, and the user experience still isn’t what it could be.

There's been some speculation that CMS soon will introduce its own five-star rating system on the site, as it has for its Nursing Home Compare site. That doesn’t exactly mollify me. I wish everyone would let go of the idea that making data accessible to lay people has to mean dumbing it down to a letter grade or a certain number of smiley faces. Doing that might actually make consumers less likely to dig deeper and see for themselves how local hospitals compare against each other and against the national and regional averages on a given metric.

In explaining its five-star rating system for the nursing home site, CMS offers this: “Caution: No rating system can address all of the important consideration that go into a decision about which nursing home may be best for a particular person.” Yeah, no kidding.

I’m trying to stay positive, but the slow rate of progress makes it difficult. As we’ve noted before on this blog, there’s still precious little transparency on pricing in healthcare. That fact, coupled with the fog of quality and outcomes data that’s publicly available, makes it pretty hard for even smart, conscientious healthcare consumers to know where to turn.