12 Things I'd Change On Hospital Compare

Cheryl Clark, for HealthLeaders Media , January 9, 2014

R. Adams Dudley, MD, a quality measures expert at UCSF, suggests that the National Cancer Institute's Surveillance, Epidemiology, and End Results Program data can be used to show cancer hospitals' rates of patient survival.

"It's do-able," he says, "and it's much more an issue of political will than of technical capability" that prevents such information from being posted now.

7. Stop Avoiding Children
Except for 3 measures covering childhood asthma care, there are no measures for pediatric care. A search for several children or infant hospitals by name produced no results, such as Rady Children's Hospital or Sharp Mary Birch Hospital for Women and Newborns, both in San Diego, or Cincinnati Children's Hospital.

Because pediatric care is often covered under Medicaid, reporting of acceptable Medicaid quality measures should be required and reported too so parents can judge quality of children’s hospitals.

8. Update More Frequently
Hospital officials often wave away poor performance data by saying the numbers are old. They're doing much better now, they insist. Unfortunately, we won't find out if that's true for years.

Performance periods for many reported measures on Hospital Compare ended as much as 18 months ago and covered a period that began long ago as 4.5 years. The most recent performance periods ended March 31 of 2013 or 10 months ago.

Although CMS updates the site every three months, most measures are on a less frequent schedule. More recent rolling performance periods and shorter intervals for hospitals to check their data before public posting would help.

9. Trust but Verify
CMS now includes a page on the site for Data Sources, which explains how the data gets from the hospital's patients' charts to the federal database. But there is no explanation on whether the data is checked or audited, or how often, and the degree of sampling necessary for verification.

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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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