Online Hospital Scores Unlikely To Affect Clinical Results, Execs Say
December 9, 2014 in News
Hospital executives say that quality reports on Medicare’s Hospital Compare website might bring about targeted improvement efforts but are unlikely to have a significant effect on clinical outcomes, according to a study published last week in JAMA Internal Medicine, HealthLeaders Media reports.
Details of Study
For the study, researchers at Baystate Medical Center in Massachusetts sent a 21-question survey to leaders at 630 hospitals just before the enactment of federal penalties affecting Medicare reimbursements on Oct. 1, 2012. Researchers received 380 replies.
The questions addressed scores on the Hospital Compare site related to quality measures for:
- Patient experience;
- Process measures;
- Readmissions; and
Overall, the researchers found that 70% of respondents thought “public reporting stimulates quality improvement activity” at their organization.
However, lead researcher Peter Lindenauer said that while most respondents believed that quality reporting have led to improvement, there were “concerns about the technical details and unintended consequences” of the metrics. For example, 45.7% to 58.6% of respondents said they were concerned that other areas could be neglected as organizations focus on publicly reported quality measures.
In addition, when asked whether hospitals might alter documentation and coding practice to maximize performance:
- 57.6% agreed or agreed strongly that doing so could affect process measure scores; and
- 41.5% agreed or agreed strongly that doing so could affect patient experience scores.
Researchers also found that chief quality officers were less likely than CEOs and CMOs to think that public reporting improved care quality.
Meanwhile, the study found that hospital leaders were skeptical that scores on the website appropriately account for patient mix differences among hospitals. Specifically:
- 43.6% disagreed or strongly disagreed that differences in patient mix were appropriately taken into account when calculating mortality scores; and
- 55% disagreed or strongly disagreed that differences in patient mix were appropriately taken into account when calculating cost and volume scores (Clark, HealthLeaders Media, 12/8).