How CMS Makes Quality Data Public While Still Keeping It Secret

The federal government seems to want to keep safety data on eight hospital-acquired conditions (HACs) secret at the same time that it boasts how transparent it's being.

A favorite phrase from my college days is this, "How can you be in two places at once when you're not anywhere at all?"

That's what seems to be happening at the Centers for Medicare & Medicaid Services, which is trying to keep hospital-acquired condition safety data secret at the same time it releases it and boasts how transparent it's being.

The sensitive information under discussion involves the latest update on the rates of eight hospital-acquired conditions (HACs) per 1,000 patient discharges, for incidents that caused serious patient harm over the two-year period ending June 30, 2012. These never-supposed-to-happen events include surgical tools left inside patients, pressure ulcers, avoidable falls and trauma, incompatible transfusions, air embolisms, urinary tract and vascular infections, and poor glucose management.

Healthcare consumers, health plans, and members of any hospital's team, as well as their donors and trustees, should be able to see these numbers by hospital and compare rates with other hospitals in the region. And they can—sort of —but only if they know the multiple secret places to look.

The new data is tucked away in a site embedded within data.cms.gov, where few would ever know to search. And unless you can decode the "Provider ID," a six-digit sequence known mainly to hospital insiders and coders, you won't be able to find your hospital; the facilities are not listed by name.