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Hospital Groups Strike Back at Hospital Rating Systems

Cheryl Clark, for HealthLeaders Media, March 10, 2014

"Differences in the measures, data sources, and scoring methodologies produce contradictory results that lead to confusion for the public, providers, and governing boards, and impair the public's ability to make well-informed choices about healthcare providers," the AAMC document says.

"For data to be understood and for results to be comparable, publicly reported data should adhere to a set of guiding principles."

The guidelines suggest that hospitals look at each scorecard's merits on the validity of measures used, transparency about methodology, and purpose. For example does the scorecard specify its intended audience? Are the measures used endorsed by the National Quality Forum? Are the outcome results risk-adjusted?

'A Lot of Commercial Interest'
Does the hospital have a business relationship with the ranking company?

"Quite a few of these are what I call commercial scorecards that offer services to help improve you, and to me that's a conflict," says Michael Henderson, MD, chief quality officer for the Cleveland Clinic and a member of the committee that compiled Guiding Principles. "Because guess what? Those who take their services go up to the top of their rankings pretty quickly."

It's confusing for everybody, Henderson says, because it seems that all hospitals are number one on someone's "best" or "top" list.

Henderson says that hospitals just have to get used to the noise. "I think it's going to be exceedingly difficult to get a single agreed-upon way of doing this, because there's a lot of commercial interest in these scorecards out there, and to break that will be very hard to do."

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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.