Community Hospitals May Provide Higher Quality, Value

As legislators consider healthcare reform, it will become important to recognize and reward those hospitals that deliver outstanding value, Morrow said. But the idea of value has to be more clearly defined—with hospitals wanting to know the areas in which improvements are needed.

The Centers for Medicare and Medicaid Services (CMS) did recommend the use of value-based purchasing in November 2007, in which hospitals would be reimbursed based on the overall value that they deliver. But the agency has not officially established what value-based purchasing will look like, said Data Advantage CEO Hal Andrews.

The company is trying to expand on some of those concepts by looking at metrics CMS already uses:

• Quality, by examining data that includes CMS' core measures, patient safety, mortality, and readmission rates.


• Efficiency, by including the relative measure of the cost to the hospital for providing services.


• Affordability, by providing a relative comparison of prices charged for inpatient and outpatient services, including what hospitals ultimately collect.


• Patient satisfaction as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems, which is better known as HCAHPS.

While the data may show that a community hospital or a large academic teaching hospital may be providing excellent value for the care they provide, the report does not include information about what they are doing "to deliver a higher level of value care than other hospitals," Morrow said.

"We don't think there's really enough to know what the commonalities are," said Morrow, who said the company is organizing a summit in December to look at the issue.

"There are examples in every category [of hospitals] that are doing well, and it's easy to demonstrate that they are doing well. And we think that instead of looking to one or two hospitals that are either geographic or demographic flukes in the overall scheme of things—that we look to the top quartile performers and say: What's going on that works in Billings, MT, as well as in Nashville, TN, as well in Worcester, MA," Morrow said.

Hospitals themselves, as well as consumers, can look at hospital-specific and market-specific data by visiting the free Web site and selecting a hospital found on the map.