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Hospital Groups Strike Back at Hospital Rating Systems

Cheryl Clark, for HealthLeaders Media, March 10, 2014

The Association of American Medical Colleges has issued a list of 25 guidelines to help hospital officials evaluate rating systems that rank hospitals. Hospitals are urged to consider the validity of measures used, and transparency about methodology.

As hospitals grow increasingly frustrated with contradictory commercial rating systems that grade, score, and rank their quality of care, the Association of American Medical Colleges and other hospital groups are striking back.

They've issued a list of 25 Guiding Principles to help hospital officials judge the scorecards themselves, so they can explain results to their patients, payers, philanthropists, and board members, and if there are fees associated, so they can determine whether a survey's marketing value is worth the asking price.

When hospitals are rated, "[they] want to know, 'How do we talk with our boards, why we should put a lot of emphasis on this rating system or why we shouldn't, and where is it important?'" explains Joanne Conroy, MD, chief healthcare officer for the AAMC, which spearheaded the project last year. "They need a clear set of principles that's not their opinion to justify why they should emphasize one [rating] system and not another."

In fact, none the rating systems published to date, including those from The Joint Commission, the Leapfrog Group, Consumer Reports, Hospital Compare, the Commonwealth Fund, Truven, Healthgrades, and U.S. News and World Report, meet all of the AAMC's guiding principles. "Nobody meets them all," Conroy says.

"Some of the [scorecards] are really great at identifying their purpose, and some are really transparent about their metrics. And others are totally not," she says.

"Some of these rating organizations use proxies, because that's all they have. They don't measure what they purport to measure."

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1 comments on "Hospital Groups Strike Back at Hospital Rating Systems"


Evan Marks (3/12/2014 at 2:48 PM)
Dr. Conroys statement regarding Healthgrades is inaccurate and uninformed. First, Healthgrades publishes hospital specific measures taken directly from CMS hospital compare such as readmission rates, timely and effective care measures and HCAHPS scores. Each is properly attributed to CMS as the data source. We also attribute our 14 AHRQ PSI's to CMS data and licensed AHRQ software and their associated methodology. Regarding the 37 different in-hospital complications or in-hospital or 30 day mortality measures. All of the data sources are attributed to CMS or 18 state all payer data sources. All inclusion and exclusion rules for all measures are provided at the individual ICD9 code level. All complications identified and measured are similarly documented and published. Our risk adjustment process and scoring methodologies are all documented, published and are available free of charge or free of registration to all interested parties at our quality center on Healthgrades.com. All Healthgrades awards compiled from various quality, safety and patient experience measures are similarly documented, published and available to all interested parties at our Quality Center. In addition Healthgrades would be delighted to explain and discuss our measures, methodologies and data sources to any interested physicians, administrators, hospital, or researcher at any time...including the Chief Healthcare Officer of the AAMC. We fully support the intentions behind the guiding principles of the AAMC and look forward to working with them and all interested parties seeking to improve the safety and quality of care in America's hospitals.