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Ratings for hospitals, doctors, surgeons, home health agencies, nursing homes

September 6, 2015

Tags: rating health care, rating hospitals, rating doctors, rating home health care agencies

Updated 5-24-18. by Pat McNees
I've listed here various "scorecards" and ratings for different aspects of the U.S. health care system, because they're a step toward helping consumers figure out how to choose healthcare providers, services, and institutions. The problem is, different groups choose different ways of evaluating doctors and hospitals and to the extent that some use some punishment measures to protect consumers (measures which might work against ratings for doctors or hospitals that try to provide more and more sophisticated services, for example), and that some measures seem to conflict, this must all be taken with a grain of salt. Also, some ranking systems don't rank all hospitals in a system-- rank only those that fit criteria that group (e.g., Leapfrog) chose to rank. Be sure to take a look at the bigger picture because the ranking organization may not be. There is also at least one paradox in ranking systems: Sometimes the better academic hospitals get worse rankings (in a system such as Leapfrog) because they're better at reporting adverse events, they tend to treat more difficult cases, and they often treat patients of lower socioeconomic status, whose health may be worse to begin with.
Ratings are an important step toward making health care more transparent for consumers. Scroll to the bottom for some fairly recent criticisms and Norman Bauman's analysis of problems with various rating systems.

Quality Check. Search and compare hospitals that have received a gold seal of approval by The Joint Commission, which oversees the accreditation and certification of nearly 21,000 healthcare organizations and programs in the U.S. You can see accreditation history for each qualifying program, and quality reports are available to download. (Highly rated by HealthWeb Navigator.)

The Leap Frog Group Promotes improvements in the safety of health care by giving consumers data to make more informed hospital choices. Compares hospitals using data from survey responses. Search by location to compare hospitals against criteria such as inpatient management, maternity care, high-risk surgeries, etc. Says one health care journalist, "One caveat: If your hospital is good at finding and reporting complications, they look bad, even if they are doing everything right."

Hospital Compare (Medicare)
---CMS unveils updated hospital star ratings formula (Maria Castellucci , Modern Healthcare, 12-21-17). An explanation for after the methodology changed, so that instead of 83 five-star hospitals using CMS data there are now 337.
---Kevin MD writes: "While the federal government has steadily expanded the number of publicly available measures on its Hospital Compare website, it still falls short of what many patients, payers, and providers would like. This is particularly true in the realm of outcomes such as infections and mortality rates, and in provider-level ratings." (2015)
---What journalists should know about hospital ratings (Liz Seegert, Covering Health, Association of Health Care Journalists, 6-24-16) "Journalists should take hospital ratings with a healthy dose of skepticism, according to experts at a recent AHCJ New York chapter event. Simply looking at an institution’s overall rating is just the start. Reporting that without understanding what’s being rated and how 'success' is measured does a disservice to your audience."
---Only 251 U.S. hospitals receive 5-star rating on patient satisfaction (Sabriya Rice, Modern Healthcare, 4-16-15)
---CMS gives 215 hospitals 'five stars' for patient experience. See how yours fared on our map. (Advisory Board, 8-15-17) CMS recently updated its Hospital Compare website with new Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) summary star ratings for 3,504 hospitals.
Medicare Prepares To Go Forward With New Hospital Quality Ratings (Jordan Rau, Kaiser Health News, 7-22-16) "Despite objections from Congress and the hospital industry, the Obama administration said it will soon publish star ratings summing up the quality of 3,662 hospitals. Nearly half will be rated as average, and hospitals that serve the poor will not score as well overall as will other hospitals...The government says the ratings, which will award between one and five stars to each hospital, will be more useful to consumers than its current mishmash of more than 100 individual metrics."

HospitalFinances.org (AHCJ, Bringing transparency to nonprofit hospital finances). See New site gives access to nonprofit hospital financial data (Len Bruzzese, AHCJ, 5-23-18)

Surgeon Scorecard. ProPublica's informal website shows death and complication rates in eight types of surgery, showing results on all surgeons, good or bad. with 20 or more surgeries in a category. See USA Today story 'Surgeon scorecard' measures docs by complications.But also, see Kevin MD's criticism of (more…)