Hospital ratings — the rest of the story

By Mark Valliere

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In recent years, a great deal of energy has been invested in developing health care price and quality information, with the ultimate goal of motivating consumers to become more active and informed about their health care decisions. The goal is well-intentioned but its pursuit creates an environment ripe for confusion, one that needs and deserves further explanation.

To draw the most useful information from the various quality reporting groups, it's important that consumers get beyond the headlines. There are many quality reporting groups and they are not all created equal. They differ in the number of metrics used and how they weight and risk-adjust the data.

Generally, ratings that use more data points and are open about how they analyze the information are of higher value to consumers.

Hospital Compare, a website maintained by the Centers for Medicare and Medicaid Services, reflects perhaps the broadest effort to report hospital quality data. Based on Medicare patient data, Hospital Compare includes results of outcome, process and patient satisfaction measures for individual hospitals across the country. The information can be found at: http://www.medicare.gov/hospitalcompare.

Other ratings groups, each using their own methodology in their analysis, often come to vastly divergent conclusions based on the same baseline data. Some hospitals rated as outstanding by one group show poorly or are ignored by another. Also, ratings results from an individual group can change significantly from year to year.

We are proud of the quality care Mercy Medical Center provides to patients. Several ratings organizations that provide more in-depth analysis of the available data recently have rated Mercy as a high performer. Mercy was ranked as a Top 100 Hospital by Truven Health Analytics, a reporting group that bases its findings on a broad measure of data considering performance and outcomes in nine different categories, as opposed to other groups that may draw from only two or three data points. Truven analyzes data such as mortality and complications rates, readmissions, length of stay, cost and patient safety.

Mercy also has received numerous quality awards from CareChex, another organization that considers multiple metrics. Most recently, Mercy was ranked No. 1 in the state for Overall Medical Care, Major Orthopedic and Joint Replacement Surgery in 2013.

Leapfrog is another agency that uses more comprehensive ratings measures and where Mercy receives high marks.

In an effort toward greater transparency and to help educate consumers on quality measures, Mercy released its first-ever quality report this past year. The document is filled with information and clinical data regarding outcomes and safety initiatives at Mercy. You can find the report at www.mercycare.org/qualityreport.

By reading the report, consumers also will learn how Mercy is on the forefront of population health management through the Accountable Care Organization recently formed with University of Iowa Health Care. Already, Mercy has made a dramatic change in the way the hospital addresses escalating costs, fragmented care and uncertainties involving health care reform by joining the University of Iowa Health Alliance as one of the four founding Iowa health care partners.

In January 2010, Mercy's family physician clinic network started an innovative quality program tracking a wide variety of different metrics, such as preventive screenings. Providers increasingly are shifting their focus from treating disease to prevention with enhanced care coordination. A review of these metrics and our performance also can be found in Mercy's Quality Report.

Mercy supports transparency and availability of trusted health care information. We embrace a culture of openness and change. With these tools, consumers can learn more about the places they seek care and their providers, so they are equipped to make well-informed choices. Just remember to look beyond the surface, and know how rankings and recommendations are created before making your health care decisions.

Mark Valliere is Chief Medical Officer at Mercy Medical Center, Cedar Rapids. Comments: mvalliere@mercycare.org