Quality scores on Medicare's Hospital Compare website are unlikely to significantly improve hospital outcomes, according to a study published in JAMA Internal Medicine.
Researchers, led by Peter Lindenauer, M.D., of Baystate Medical Center in Springfield, Massachusetts, sent 630 hospitals a 21-question poll in fall of 2012, shortly before the Centers for Medicare & Medicaid Services implemented federal penalties affecting reimbursements. The questionnaire addressed the participants' Hospital Compare scores for measures involving cost, patient experience, process measures, volume, mortality and readmissions, according to the study.
Of the 380 replies Lindeanauer and his team received, 70 percent agreed that public reporting provides incentives to organizations to embark on quality improvement initiatives. Despite these results, Lindenauer said, there were concerns about potential side effects of these metrics. Up to 59 percent of respondents expressed concerns that emphasis on publicly reported quality measures could come at the expense of other areas. Fifty-seven percent of respondents agreed or strongly agreed that hospitals changing their documentation and coding practice to maximize performance could affect process measure scores, while 41.5 percent said it could impact patient experience scores.
Chief quality officers, researchers found, were less likely to believe public reporting boosted overall care quality than either CEOs or chief medical officers. Hospital leaders were also unsure that website scores appropriately account for hospitals' different patient mixes. Forty-four percent disagreed or strongly disagreed that such variations were appropriately factored into mortality scores, and 55 percent disagreed or strongly disagreed they were properly accounted for when calculating scores for cost and volume, according to the study.
A March study determined online hospital ratings do not help patients adequately compare hospital quality or performance data, as there is too little variation in data for patients' local hospitals for them to differentiate, Fierce Healthcare previously reported. "There's a missed opportunity to provide those patients with more transparent and reliable information to better influence their decision-making," said lead researcher Kyan Cyrus Safavi, M.D.
To learn more:
- here's the study abstract