IBM Watson Health Names Top 100 Hospitals

The 2019 study finds top-performing U.S. hospitals provide better care at lower cost and higher profit margins than peers.

IBM Watson Health this week published its annual list of what its research shows are the nation's 100 Top Hospitals.

The study, which has been conducted annually since 1993, is based on a balanced scorecard that uses publicly available data for clinical, operational, and patient satisfaction metrics.

Unlike other top hospital awards, IBM Watson Health's winners do not apply for awards, and they do not pay to market this honor.

The top-performing hospitals achieved better risk-adjusted outcomes while maintaining both a lower average cost per patient and higher profit margin than peer group hospitals that were part of the study, said Ekta Punwani, 100 Top Hospitals program leader at IBM Watson Health.

"At a time when research shows that the U.S. spends nearly twice as much on healthcare as other high-income countries, yet has less effective population health outcomes, the 100 Top Hospitals are setting a different example by delivering consistently better care at a lower cost," Punwani said.

The key performance measurements included:

• Higher Survival Rates: The 100 Top Hospitals winners achieved survival rates that were 24.9% higher than those of peer hospitals.
   
• Fewer Complications and Infections: Patients at winning hospitals experienced 18.7% fewer complications and 19.3% fewer healthcare-associated infections than peer group hospitals.
   
• Shorter Length of Stay: Winning hospitals had a median severity-adjusted length of stay that was one half-day shorter (0.5) than peers.
   
• Shorter Emergency Department Wait Times: Overall, winning hospitals delivered median emergency department wait times that were 17.3 minutes shorter than those of peer group hospitals.
   
• Lower Inpatient Expenses: Average inpatient costs per discharge were 11.9% lower (a difference of $830 per discharge) at 100 Top Hospitals versus peer group hospitals.
   
• Higher Profit Overall Margins: Winning hospitals maintained a median operating profit margin that was 11.9 percentage points higher than peer group hospitals.
   
• Higher Patient Satisfaction: Overall hospital experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), was rated 3% higher for winning hospitals than peer group hospitals.

The IBM Watson Health 100 Top Hospitals winners outperformed peer group hospitals within all 10 clinical and operational performance benchmarks evaluated in the study: risk-adjusted inpatient mortality index, risk-adjusted complications index, mean healthcare-associated infection index, mean 30-day risk-adjusted mortality rate, mean 30-day risk-adjusted readmission rate, severity-adjusted length of stay, mean emergency department throughput, case mix- and wage-adjusted inpatient expense per discharge, adjusted operating profit margin, and HCAHPS score.

Extrapolating the results of this year's study, if all Medicare inpatients received the same level of care as those treated in the award-winning facilities:

• More than 103,000 additional lives could be saved;
   
• More than 38,000 additional patients could be complication-free;
   
• More than $8.2 billion in inpatient costs could be saved; and
   
• Approximately 155,000 fewer discharged patients would be readmitted within 30 days.

In addition to the 100 Top Hospitals, the IBM Watson Health study also recognizes the 100 Top Hospitals Everest Award winners. These are hospitals that earned the 100 Top Hospitals designation and also are among the 100 top for rate of improvement during a five-year period. This year, there are 15 Everest Award winners.

IBM Watson Health researchers evaluated 3,156 short-term, acute care, non-federal hospitals. All research was based on: Medicare cost reports, Medicare Provider Analysis and Review data, and core measures and patient satisfaction data from the Centers for Medicare & Medicaid Services Hospital Compare website.