12 Things I'd Change On Hospital Compare

Cheryl Clark, for HealthLeaders Media , January 9, 2014

Quality of care at many of these system-wide facilities varies dramatically. Not reporting that variation by individual facility defeats the purpose of having quality reporting. Payers and providers should want these performance measures delineated.

3. Military Hospitals and the VA
The public has a right to know about the quality of care in hospitals financed by the Department of Defense. Yet more often than not, a quality measure for the nation's 153 VA hospitals shows up as "Not Available." Likewise for military hospitals such as National Naval Medical Center in Bethesda, MD., or Naval Medical Center San Diego, or Naval Hospital Camp Pendleton, CA.

Military hospitals covered under the TriCare and other Department of Defense payment systems should be required to report quality measures for adult care the same as non-military hospitals do now.

4. Let Hospital Compare Compare
One of the most frequent complaints I hear about the site is that users are unable to compare more than three hospitals at a time. If both state and national data are sought, only one hospital can be seen at a time.

5. Follow the Money
For an increasing number of measures now posted on the site, performance is paired with a financial bonus or a financial penalty. For those measures, for example, 30-day readmissions, which carries a penalty up to 3% of a hospital's base Medicare DRG payments next year, CMS should include an explanation of whether that hospital's readmission rates avoided or incurred that penalty, and how much.

Coming soon, penalties for hospital-acquired conditions of 1% and value-based purchasing incentive payments of 2%. CMS should explain whether a hospital's score deserved a penalty or reward in those categories too.

6. Report Measures of Cancer Care
Care for patients with cancer eats up $1 in every $10 federal dollars spent on healthcare, yet there are no measures now reported nationally for cancer care. For hospitals that have been accredited to treat patients with cancer from reputable organizations such as the Commission on Cancer, show those hospitals' accreditation status, for which forms of cancer.

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4 comments on "12 Things I'd Change On Hospital Compare"

Teresa Ryals, RNIII/Quality Management (1/10/2014 at 7:49 AM)
As someone who has reported data to CMS for our facility since the 10 Starter Measures, I agree with this article. One thing not mentioned is the large number of hospitals that have "too few cases" to report. The majority of the hospitals reporting have fewer than 100 beds, many less than 50. Ours has 21. Curious as to how, if numbers were reported no matter how small, would effect the results.

Michael Cylkowski (1/9/2014 at 5:34 PM)
Nice article Cheryl. I would like to see more actual outcomes data like the kind Walmart looks at to determine their Centers of Excellence. That would be meaningful.

Leah Binder (1/9/2014 at 5:15 PM)
A superb analysis of the politically-motivated shortcomings of Hospital Compare.




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