Centers of excellence not linked to lower mortality, readmission rates

Hospitals designated as centers of excellence do not always achieve better patient outcomes, suggest the findings of a study published in JAMA Internal Medicine.

For the study, researchers from Philadelphia-based Penn Medicine examined mortality and readmission rates for 62 New York hospitals performing percutaneous coronary interventions in 2015. Half of the hospitals were designated as centers of excellence through one of the following programs:

  • Aetna's Institutes of Quality for cardiac medical interventions — five hospitals
  • Cigna's Centers of Excellence for cardiac catheterization and angioplasty — nine hospitals
  • Blue Cross Blue Shield's Blue Distinction Centers for cardiac care — 17 hospitals

Cigna- and BCBS-designated centers of excellence did not show any differences in risk-standardized 30-day mortality rates after a PCI when compared to other hospitals. Aetna-designated hospitals had a higher average 30-day mortality rate after a PCI (1.4 deaths per 100 cases) compared to undesignated hospitals (1.1 deaths per 100 cases).

In addition, average 30-day readmission rates after a PCI also did not differ between centers of excellence and other facilities.

Researchers suggested payers may be assigning center of excellence designations based on cost or other nonclinical factors. They said more work must be done to improve criteria to better identify which hospitals outperform peers.

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