'It's a Black Box'
Leah Binder, President and CEO of the Leapfrog Group, says that while the AAMC's principles "adhere to Leapfrog's standards for our own public reporting," geared for both patients and providers, presented with 100% transparency including the data and methodology, and use validated measures, the effort seems to deny free speech.
"We wish AAMC would focus their enormous expertise and leadership on expanding transparency, instead of this quixotic attempt to curtail it. In America, not even an organization with the impressive credentials of AAMC gets to decide which speech is acceptable."
Conroy says the hospital groups may try to go further in future documents, and publicly name organizations that have met most or all of the principles. But this time around, "we didn't want people to think that we were creating principles that were inherently biased."
She gave as one example, Healthgrades, which she says "has a proprietary algorithm, and that means there's no way for me to understand why I didn't score well, or did score well. It's a black box. They don't specify their data sources."
Hospitals, as well as the physicians who refer patients to them, should be prepared for more rankings going forward, especially with public quality measures becoming increasingly numerous, specific and used to structure payment, Conroy says. "There are at least 14 out there now; this is like a new enterprise, and they are certainly going to proliferate."
Conroy says that as hospitals digest these Guiding Principles, there will "be some pushback on these rating systems to improve their processes and be more transparent. And I think we'll all get better."