PROVIDENCE – Most of the time, in an emergency, patients end up at the hospital closest to them. But often, they have a choice – say, if they live within five minutes of both The Miriam Hospital and Memorial Hospital of Rhode Island, or if they plan ahead to go in for surgery.
To help patients make informed choices, the U.S. Centers for Medicare & Medicaid Services set up a Web-based tool called “Hospital Compare” that allows them to learn how each hospital stacks up on selected quality measures.
For example, if patients are choosing between Miriam, Memorial and Roger Williams Medical Center to get an operation, they might want to know the share of patients at each hospital who get preventative antibiotics one hour before the incision: 81 percent, 95 percent and 93 percent, respectively.
But they also might want to know that Miriam does far more surgeries: Its percentage applied to 606 patients, vs. Memorial’s 223 and Roger Williams’ 287. And they might want to note that a full 80 percent of Miriam patients said they would recommend the hospital, while 66 percent and 64 percent, respectively, said the same about Memorial and Roger Williams.
Or maybe they would want to know how much Medicare would pay each hospital for the same procedure – say, a non-laparoscopic gallbladder removal. Turns out Miriam receives the least, at $16,352, compared with $18,227 at Memorial and $18,589 at Roger Williams.
You can look it all up at www.hospitalcompare.hhs.gov. The patient-volume and Medicare-payment information is brand new, part of an effort by the CMS to promote what has been dubbed “value-driven health care,” a twist on old-fashioned consumerism.
“For the first time, consumers have the three critical elements – quality information, patient satisfaction survey information, and pricing information for specific procedures – they need to make effective decisions about the quality and value of the health care available to them through local hospitals,” the CMS said in a news release.
“By enhancing these resources, Medicare is strengthening its commitment to use the transparency of quality information to help give consumers more choice about the quality of their health care and how they may be able to lower their health care costs,” U.S. Health and Human Services Secretary Mike Leavitt said in the release.
The Hospital Compare site now provides information on 26 quality measures, which include “process of care” measures – meaning how often a hospital does certain things that are recommended, such as giving aspirin to heart-attack patients – and mortality measures.
In addition, CMS has now added 10 “patient experience of care” categories, such as how often doctors and nurses communicate clearly, how quiet a hospital is, and so on.
The latter information is drawn from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey, known as HCAHPS, the first national, standardized, publicly reported survey of patient perspectives on care they experience during a hospital stay.
More than 2,500 hospitals around the country have been collecting information from a random sample of discharged patients who were treated for a wide range of conditions between October 2006 and June 2007.
Lastly, there’s the payment and volume information, a key piece in national efforts to make consumers more aware of how much they care they receive actually costs.
The pricing data comes from payments Medicare made for treatment of beneficiaries with certain illnesses from October 2005 through September 2006. The information reflects what Medicare pays the hospital for these services, not what beneficiaries pay, but the CMS said it is providing the data because “a better understanding of the cost of care leads to more informed decision-making, one more way beneficiaries can help improve their health and support the longer term financial health of Medicare.”
The enhanced Hospital Compare site fits with the four cornerstones of “value-driven” health care outlined in an August 2006 executive order by President George W. Bush that focused on ensuring transparent quality and price information, interoperable health information technology and incentives for high-quality, efficient health care delivery.
“Hospitals have already stepped up their efforts to improve the care they provide based on the quality information that has been publicly reported over the past few years,” CMS Acting Administrator Kerry Weems said in the news release.
“This new information should help accelerate that process as more and more people pay attention to this important information that is now available to the public,” he added. “Collectively, the quality, patient satisfaction, volume, and pricing information will help us assure patients and their families that they have the information they need about the care they are receiving while serving as a catalyst to continue to improve the care delivered in our nation’s hospitals.”
The U.S. Centers for Medicare & Medicaid Services (CMS) is an agency of the U.S. Department of Health and Human Services. It created the Health Compare Web site to help patients make good decisions about health care and encourage hospitals to improve the quality of care they provide. For more information, go to www.hospitalcompare.hhs.gov.
