Hospital Compare adds more data to help consumers compare facility performance

WASHINGTON – The Hospital Compare website run by the Centers for Medicare & Medicaid Services has been expanded, with new data on outpatient surgical care and imaging, heart-attack care, and more, plus several data updates.
The information, now also available on a larger federal website called HealthCare.gov, is meant to help consumers identify the best hospital for general care or for a specific procedure. Previously, only inpatient measures were included.
“The more information consumers and patients have, the better the options and choices are for them when it comes to their health care,” said Kathleen Sebelius, secretary of health and human services, in a news release. “HealthCare.gov is designed to put the power of information at the fingertips of Americans, and our quality compare tools are a critical part of this new website.”
The sites cover Medicare volume and payment data as well as a slew of quality measures, from patient satisfaction (Did doctors and nurses always communicate well? Did they keep pain under control at all times?), to “process of care” measures (Were the proper precautions taken before surgery?), to outcome measures (death and hospital readmission rates).
Some of the newly added data fall in those categories, including how well hospitals protect outpatients from surgical infections and how well they respond to heart attacks. In addition, a whole new category has been added, for use of medical imaging.
One of the new measures is the share of outpatients with low back pain who had an MRI without trying recommended treatments first, such as physical therapy – which CMS says could indicate that the facility is doing too many unnecessary MRIs for low back pain.
A comparison of The Miriam Hospital, Roger Williams Medical Center, and Memorial Hospital of Rhode Island, for example, shows very different rates: 30.1, 48.3 and 33.9 percent, respectively.
On average, one-third of Medicare beneficiaries get an MRI (magnetic resonance imaging) of their lower back when they complain of pain, according to CMS. The procedures are generally safe, CMS officials note, but studies show that overusing MRIs for lower back pain could cause patients unnecessary stress, risk and cost. Other tests, however, such as computed tomography (CT) scans, may also expose them needlessly to radiation.
“By reporting data on services provided in hospital settings like imaging on Hospital Compare, we can highlight the importance of this issue for patients and their families,” said Acting CMS Administrator Marilyn Tavenner. “For some time, Medicare beneficiaries have had access to reasonable and necessary imaging technologies, which have revolutionized how well doctors and patients diagnose and treat a host of diseases. But by adding information to the website today, we can help patients and their families to understand the risks associated with these technologies and talk with their doctors about which hospitals are most likely to help patients reduce those risks.”
Another measure that consumers might find helpful is the share of outpatients who had a follow-up mammogram or ultrasound within 45 days after a screening mammogram. CMS says a number “much lower” than 8 percent may mean there’s not enough follow-up, while a number “much higher” than 14 percent may mean there’s too much unnecessary follow-up.
Again, the rates vary considerably among local hospitals: 12.1 percent for the Miriam, 4.9 percent for Roger Williams, and 9.0 percent for Memorial (all Rhode Island hospitals are listed on the site; these three were chosen because they’re relatively close to one another).
The imaging data are based on claims for Medicare patients only.
In addition to the new outpatient care measures, CMS updated data for outcomes of inpatient hospital care, with new 30-day mortality and readmission rates for inpatients admitted with heart attack, heart failure, and pneumonia, running from July 2006 through June 2009.
Nationwide, the heart attack mortality rate declined slightly, from 16.6 percent in 2005-08 to 16.2 percent. The mortality rate for heart failure and pneumonia held steady, at 11.2 and 11.6 percent, respectively. Readmission rates for all three occurences also were fairly steady, at 19.9, 24.7 and 18.3 percent, respectively.
Hospitals’ individual rates are risk-adjusted and reported as better than, no different from, or worse than the U.S. national rates. On the three mortality measures and heart attack readmissions, the Miriam, Memorial and Roger Williams are all rated “no different” than the U.S. rate. On heart failure and pneumonia readmissions, Memorial is rated “worse” and the others are rated “no different.”