Panelists for “Rankings and Ratings: An Update on U.S. News’s Hospital Quality Reporting,” described recent methodologic changes to the public reporting program, explained how the methodologies are likely to further evolve, and reflected on the first year of U.S. News reporting on common procedures and conditions.
Major takeaways from the conference session include:
- The U.S. News health rankings team plans to expand Best Hospitals for Common Care in 2016 and beyond. Among other changes, rankings will include new cohorts: aortic valve replacement, abdominal aortic aneurysm, lobectomy and colectomy related to cancer, and obstetric-perinatal outcomes.
- In the future, U.S. News intends to expand evaluations to cover individual physicians and regional health systems or groups of hospitals.
- Panelists emphasized the need for hospitals to become more transparent about their outcomes by publicly reporting data from clinical registries.
Ben Harder, chief of health analysis and a managing editor at U.S. News & World Report, gave the bulk of the presentation. Harder oversees data use in U.S. News’ suite of decision support tools for health care.
Four years ago, U.S. News introduced the Best Regional Hospitals rankings, by metro area and state, to give consumers objective measures of success in providing high-quality care among hospitals in their communities. This year, a new offering, Best Hospitals for Common Care, added another dimension.
Harder described an important component that emerged from Common Care data: the relationship between surgery in low-volume hospitals and increased (but still rare) deaths. “A large part of that picture is appropriateness,” he said.
The latest Best Regional Hospitals rankings featured several changes in methodology: The Common Care ratings became a rankings factor, eligibility was limited to general acute-care hospitals, and specialty hospitals were ineligible.
Reputation-only specialties – ophthalmology, psychiatry, rehabilitation and rheumatology – were eliminated from Best Regional Hospitals’ consideration, because of the lack of objective measurements.
Harder noted that the risk-adjustment model used by the U.S. News ranking team differs from that of the Centers for Medicare & Medicaid Services. One difference is that U.S. News rankings incorporate socioeconomic status in hospital readmission results. Therefore, results for procedures such as joint replacement or conditions like COPD could vary between the ranking systems.
He addressed current data limitations in rankings: the use of retrospective data and the lack of clinical variables like body mass index, which can affect patients’ medical and surgical outcomes. Access to clinical registries and databases would serve to improve public reporting and transparency, he said.
Procedures to assure accurate data reporting from hospitals are being further strengthened, said panelist Murrey Olmsted, a senior methodologist and health researcher with RTI International. Olmsted works with the Best Hospitals and Best Children’s Hospitals rankings as a contractor for U.S. News.
U.S. News’ Geoff Dougherty, senior health services researcher, said U.S. News will perform the 2016 analytics for Common Care entirely in house, another change.
Harder summed up the motivation behind ranking hospital quality: “We are here to help patients make better decisions.”