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Hospital Groups Strike Back at Hospital Rating Systems

Cheryl Clark, for HealthLeaders Media, March 10, 2014

'It's a Black Box'
Leah Binder, President and CEO of the Leapfrog Group, says that while the AAMC's principles "adhere to Leapfrog's standards for our own public reporting," geared for both patients and providers, presented with 100% transparency including the data and methodology, and use validated measures, the effort seems to deny free speech.

"We wish AAMC would focus their enormous expertise and leadership on expanding transparency, instead of this quixotic attempt to curtail it. In America, not even an organization with the impressive credentials of AAMC gets to decide which speech is acceptable."

Conroy says the hospital groups may try to go further in future documents, and publicly name organizations that have met most or all of the principles. But this time around, "we didn't want people to think that we were creating principles that were inherently biased."

She gave as one example, Healthgrades, which she says "has a proprietary algorithm, and that means there's no way for me to understand why I didn't score well, or did score well. It's a black box. They don't specify their data sources."

Hospitals, as well as the physicians who refer patients to them, should be prepared for more rankings going forward, especially with public quality measures becoming increasingly numerous, specific and used to structure payment, Conroy says. "There are at least 14 out there now; this is like a new enterprise, and they are certainly going to proliferate."

Conroy says that as hospitals digest these Guiding Principles, there will "be some pushback on these rating systems to improve their processes and be more transparent. And I think we'll all get better."


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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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.