Community Hospitals May Provide Higher Quality, Value

Some of the highest value hospital care actually may be provided by nearby community-based hospitals, according to the 2009-2010 Hospital Value Index released Tuesday that ranks hospitals by an analysis using publically available data on quality, affordability, efficiency, and patient satisfaction performance data.

"What's interesting when you run studies of this kind [is that the hospitals] are not always who you think they might be. They're not always the big brand. They're often a community hospital that's serving a smaller rural or even a suburban market," said John Morrow, a senior advisor to Nashville-based Data Advantage, a privately held health information company, which created the index. "They are not a single model of healthcare, but they shine the light so others may follow."

Of the more than 4,500 hospitals that were analyzed by the company, 747 were identified as providing "best in value" care. The company noted that if all hospitals across the country performed at the average benchmark for the "best in value" hospitals, about 9.3% of costs—or approximately $60 billion—could be eliminated from annual hospital spending.

With the inclusion of many community hospitals, the analysis suggests that consumers may find higher values closer to home and that policymakers may want to expand their search for models of reform beyond the bigger name teaching hospitals, according to Morrow.

The highest ranked hospitals in the study were found to be geographically diverse—with the top 10 hospitals located in Dothan, AL; Minden, LA; Tawas City, MI; Clarksburg, WV; Gastonia, NC; Maysville, KY; Elmira, NY; Mechanicsville, VA; Holland, MI; and Winston-Salem, NC.

Among the 100 largest metropolitan areas, the highest ranked markets are Charlotte, NC; Rochester, NY; Grand Rapids, MI; Pittsburgh, PA; and Knoxville, TN. Hospitals in larger cities, such as Los Angeles, San Francisco, and Chicago were found to score lower, based on the index. Overall, markets with a population of less than 2 million people were found to outperformed markets with a population of more than 2 million.

The top five states in delivering value were:

• North Dakota
• Iowa
• Montana
• South Dakota
• Maine

The bottom five states were:

• New Mexico
• Arkansas
• California
• Hawaii
• Nevada

California had only two hospitals among the top 100 "best in value" hospitals, while New York, Alabama, and Iowa each have at least six hospitals in the top 100.