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12 Things I'd Change On Hospital Compare

Cheryl Clark, for HealthLeaders Media, January 9, 2014

Hospital Compare is a valuable, yet deeply flawed tool for reporting on hospital quality measures. It doesn't have to be that way.

The most complete website for quality reports for the nation's 4,500 acute care facilities is Hospital Compare, which is managed with a lot of taxpayer resources by the Centers for Medicare & Medicaid Services. The agency has gradually expanded the number of measures it reports on the site from a few dozen three years ago to almost 100, and there are many more to come.

But Hospital Compare remains a troublesome and deeply flawed system in many ways. In many conversations with hospital and policy officials during the course of my reporting, the wails of complaints come in sighs and groans. These are some of the words I've heard used to describe Hospital Compare: Outdated, clumsy, misleading, confusing, overly complicated, and irrelevant.

So as the new year is just getting under way, it seems like a good time to ask: If I were in charge of Hospital Compare, what would I change, add, or take out, to make the site more useful?

I had some helpful suggestions from some of the smartest researchers and experts I know in public reporting. Of course, I asked CMS to comment, but was told their officials could not respond in time to meet my deadline. If I do hear from them, I may address their comments in an upcoming column.  

For now, here's what I'd change on Hospital Compare:

1. Lake Wobegon Syndrome
Almost all hospitals appear to perform at a national average, with too few appearing to be "worse than" or "better than." For example, for the measure on hospitals' rates of mortality within 30 days of discharge for patients admitted with a heart attack, only 0.7% of 2,634 hospitals with enough heart attack cases reported, were worse than the U.S. national average. Only 2.9%, were better than the national average. All the rest were average.

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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.