Hospitals give report cards a taste of their own medicine

The proliferation of different and sometimes contradictory hospital report cards is confusing patients. People want reliable information to make informed decisions about their care. Instead, they find a cacophony of contradictory reports and ratings.

To help make sense of report card chaos, HANYS published our new Report on Report Cards, which evaluates and ranks hospital report cards. In our report, we explain why some are better than others based on the data, valid measures and timeframes used.

Before the internet, people used to rely on word-of-mouth recommendations from trusted physicians, family and friends to choose a hospital. A hospital's reputation for specific procedures, as well as general patient care, was everything.

It still is. But today, people Googling hospitals soon discover that there is a lot of contradictory — and potentially misleading — information out there. 

Hospital report cards are not cutting it

Patients, families and healthcare providers shouldn't have to dig through multiple different hospital report cards and guess which ones might be most accurate and useful. Even experts struggle to decode the difference between stars, letter grades, points and national rankings.

To make informed decisions about their healthcare, people need meaningful, accurate, reliable and relevant information specific to their unique healthcare circumstances. This information should be based on a standard set of measures that have been proven to be valid, reliable, evidence-based and a true reflection of healthcare quality.

The trouble is, not all report cards are created equal. Each hospital report card, whether it’' Leapfrog, U.S. News & World Report or CMS, uses its own approach. They decide which measures to include or exclude and often use different data sources and timeframes. Some even use self-reported surveys.

Instead of using detailed clinical data from medical records, many report card organizations use administrative information from medical bills to draw conclusions about care quality. Many report card organizations use composite measures, which may not be an accurate representation of hospital quality.

To further complicate matters, hospital report cards rely heavily on publicly available data sets — based on the mostly age 65+ Medicare population. These outdated data are often not generalizable to the entire population, particularly for patients looking for maternity care or other services that lend themselves to prior decision-making.

Making sense of the report card chaos

HANYS’ Report on Report Cards, provides an easy-to-understand ranking of 12 government, nonprofit and for-profit hospital quality report cards. It explains in depth how the proliferation of report cards confuses patients while adding burdensome reporting and EHR requirements that divert provider resources away from patient care.

Not surprisingly, HANYS' Report on Report Cards found wide variation in ratings among the 12 report cards. The highest-rated report cards tend to be government reports, while private companies fared worse.  

HANYS uses a five-star system that evaluates the report cards on factors such as methodology, use of evidence-based measures that are endorsed by/aligned with national government-based or accrediting organizations, and use of appropriate data. 

None of the 12 reports got five stars. For example, the Leapfrog Group Hospital Safety Grade received only two stars in our evaluation. Why? Leapfrog fell short on important criteria related to its business model, reliability of data, consistency, data alignment and risk adjustment. 

Streamline, align and focus on the measures that matter

Consumers deserve accurate, meaningful information about healthcare quality so they can make decisions about their care. All healthcare providers agree that targeted quality measurement helps improve patient care, outcomes and experience.

Like patients, providers are frustrated with the proliferation of confusing report cards. We believe it's high time for all reporting organizations to reduce the number of hospital report cards and to align and focus on measures that matter most for patients and that accurately reflect hospital quality.

More articles on rankings and ratings:

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