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Surgical Survival Predictors May Be Next Big Quality Metric

Cheryl Clark, for HealthLeaders Media, May 19, 2011

What's next for value-based purchasing metrics, hospital transparency, and quality scoring? Hospitals, get ready.

By now, you're getting used to the idea that public scoring and pay-for-performance have arrived. The 33 process and outcome measures hospitals  must perfect to earn up to 2% of their Medicare DRG payments – the first to take effect on July 1 – are set for the next two years.

Down the road, the Affordable Care Act says, 'The Secretary shall' select additional process or outcome measures to determine each facility's paychecks going forward. What likely endpoints will those be? What weak spots in their systems should providers be rushing to improve?

I put that question to Leah Binder, CEO of the 10-year-old Leapfrog Group, the nation's first healthcare performance coalition to evaluate and post hospital performance comparisons online. The coalition of 65 employers purchases healthcare for 34 million people, and now publishes data on 1,224 voluntarily participating hospitals with dozens of mortality and system quality metrics.

Surgical "survival predictors," will be key, Binder replies, without missing a beat.  Leapfrog's website displays predictors of death during hospitalization for patients undergoing six high-risk surgical procedures for the last two years:

• Pancreatic resection
• Esophageal resection
• Heart angioplasty
• Heart bypass surgery
• Aortic valve replacement and
• Abdominal aortic aneurysm repair

Only those hospitals with sufficient numbers of procedures are included. This isn't an old 30-day mortality statistic for conditions such as pneumonia, as in the 2014 VBP score. These numbers represent a patient's chance of future mortality.

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2 comments on "Surgical Survival Predictors May Be Next Big Quality Metric"


John Rosenstock (5/24/2011 at 9:32 AM)
I would include gastric bypass surgery in the list as the mortaility rates can be very high at some hospitals.

Catherine Smith (5/20/2011 at 4:17 PM)
Healthcare transparency is a good idea in an ideal world. I am grateful to be able to look at publicly reported data and be able to determine what facility has the better outcomes, morbidity, and mortality rates in order to promote positive patient outcomes and consumer choice.However, the idea that the consumer actually has the ability to choose a top 10 percentile hospital is not reality. The reality is...the insurance carrier dictates what provider you choose. If the top 10 percentile facility is not in the insurance network then there is no choice. Unless a person is indigent, on Medicare, or independently wealthy.