Likewise, for the measure rating hospitals rates of complication and death following hip and knee surgery. Of 2,750 hospitals that had sufficient numbers of joint replacement surgeries, 95% were average, 2.5% better and 2.5% worse.
One reason given for the wide range of hospitals in the average portion of the curve is that except for the few that are very, very good and the few that are very, very poor performers, everyone else is statistically the same. If that's true, then reporting the measure doesn't serve anyone except payers and patients of those few dozen hospitals at either end of the spectrum. CMS should improve on the measure to give the public useable information.
And if those hospitals in the lowest decile or quartile are really that bad, maybe they should come under review that questions their ability to continue receiving federal reimbursement for care of those diagnostic groups of patients. As one physician suggested—and I don't think he was kidding—for those extremely poor performers, perhaps CMS should "post a stop sign, something that says, 'Watch Out.' "
2. Report by Bricks and Mortar
Healthcare systems with more than one building where acute care is provided are often allowed to report under one provider number, even though the buildings are miles apart, with different staffing, different physicians, different equipment, and different patient populations. In San Diego, where I live, UCSD Medical Center has two locations, one in wealthy La Jolla and the other in Hillcrest in close proximity to an area with a large number of the city's poor.