Feds Buy Newspaper Ads to Tout Hospital Comparisons
The government often gets blamed for stifling competition, particularly in health care. Now, Medicare wants to spur consumers to think about quality when choosing a hospital.
The Centers for Medicare and Medicaid Services is shelling out $1.9 million for ads in 58 daily newspapers in 49 states comparing hospitals to one another. The ads will show how well patients said they got the help they needed when they needed it, and how consistently the hospital gives surgical patients antibiotics. They’ll also show the statewide averages for those benchmarks. All told, the ads will include more than 2,500 hospitals, the Associated Press reports.
The Medicare honchos want you to be intrigued enough by the ads to surf on over to their Web site Hospital Compare site for more info when you’re considering which hospital to patronize.
Publicity over changes made to the site in March helped quadruple traffic on the site, to about 600,000 page views a week. HHS secretary Michael Leavitt tickled an audience of journalists then by saying hospital quality measurement is just leaving the “Pong era.” (We couldn’t resist reprising some Pong footage from the YouTube archive.)
Since we don’t all live Lake Wobegon, some facilities are faring worse than others. Just 41% of patients at Sibley Memorial Hospital in Washington, D.C., got help when they needed it, compared with 57% at Georgetown University Hospital, the AP reports.
Critics have called Hospital Compare a decent start, but woefully lacking in “outcomes” measures – ones that tell you how patients actually fare after being treated at the hospital. Instead, the site mostly measures procedures, or how well the facility follows guidelines like giving heart-attack patients aspirin on admission. The site’s only mortality gauge now – for heart attack and heart failure – lump virtually all hospitals into an oversize “normal” category, with just a handful ranked above or below normal.
Kerry Weems, the Medicare agency’s acting administrator, said the money CMS is splashing out on advertising doesn’t come at the expense of improving Hospital Compare. “We think the money we’ve spent is well spent,” Weems said. CMS plans to add pneumonia mortality rankings in June –- and may even provide a more useful way to compare mortality rates.
My only answer (a la Warren Buffett) is: Then What? Apparently the geniuses at CMS think patients actually have a choice in the hospitals they utilize. Don’t they realize that the insurance companies and physicians control this game? How many patients would utilize a hospital that got great ratings if it was not a “covered hospital” under their plan?? Hospital charges are about 3 times the amount of the physician’s charges so most patients can ill afford utilizing a hospital of their choice if their insurance plan won’t cover it. Moreover, even if a hospital were covered by insurance, the physician may not have admitting privileges at that hospital anyway. So do you think any patient is going to give up the services of a physician they know and trust just because the box they’ll be staying in has a few negative ratings? Get real.
Transparency - the buzzword in many areas of health care — has less meaning than it does in other industries. Take an example: everyone thinks the Cleveland Clinic is a great hospital. In some ways it is, and I know of many people who have flown there to get their cardiac issues addressed. But look on hospitalcompare.hhs.gov at the percentage of people who got emergent PCI (angioplasty) when they presented there with a heart attack: 56%. That’s incredibly low and arguably represents lousy care; hospitals in my area - Boston - do much better. But is that going to change people’s perception and behaviour when that hospital is ranked #1 in cardiac care on the US News and World Report annual rankings? And, as Anonymous has pointed out, there are other sigificant forces that determine where people get their care.
I love it when retail/restaurant/manufacturing people say they want to make health care transparent like their industries, with such information making purchasing decisions “rational.” They are truly ignorant harboring such simplistic ideas.
This an interesting tactic by CMS because the site is not user friendly for average patients by any means. Does anyone know what markets CMS has chosen to advertise in??
The CMS website is not organized in a way that is easy to get at the data. Most computers need WinZip to just download the data and then open it. After that it is tough to compare if you are not a healthcare professional. The data needs to be reconfigured on a web site easier to navigate and use. See www.healthcaresoundoff.com for more comment and tips.
I think the main point in measuring quality outcomes in this case is not necessarily to change patient behavior, but to change hospital behavior (performance). After all who wants to be the poor performer in a group? And who wants to be associated with a poor performer? Competition can be a good thing.
Just what do Insurance companies cover anymore when it comes to Health Care. Agree or not, A Person who is at risk or has a disease really stands no chance at receiving the quality care they deserve due to the decision makers. If someone for example is at risk for a Heart Attack or has Cancer they are most likely to see huge increases in premiums to a point they can not afford the payments. Consequently the individual will be forced to cancel his policy or the Company will Cancel him or her due to his condition. Let’s take a look at the definition of Insurance. Barron”s Law Dictionary defines Insurance as the benefit arising from the agreement by the insurer to provide the insured for a consideration money or some other benefit in the event of the destruction or loss of, or injury to, a specified person or thing in which the other has an interest. Thus, payment under the agreement by the insurer becomes a contractural obligation only when a contingency arises, which may include loss or injury not only from a specified subject, but of a specified peril. There must be a risk of loss to which one party may be subjected by contingent or future events and an assumption of it by legally binding arrangement by another.” There you have it a basic definition of Insurance. Do Hospitals have to assume risk even though there is a risk of peril. Mortality rates will lower the rankings of Hospitals obviously if they assume risk and there are large mortality rates. So the question is becoming are Hospitals obligated to treat an at risk patient, Can an Insurance Company Cancel an at risk Consumer at will. Where are the Regulators when it comes to Moral Obligation and Above all Accountability. Some Hospitals assume more risk then others therefore their rankings in certain categories may be lower than other Hospitals who are more image conscious. Personally I think everyone should have the right to Health Care and obviously the Current system is not working. This is why as a Health Care Professional I continue to educate Consumers towards an answer to The Current Health Care Crisis we face here in The US. It is called Consumer Driven Health Care and The Company I would like to see provides Health Care Benefits not insurance to everyone no matter what their condition is and it is not left up to the bean counters to determine if the individual receives care or not. www.deliveringonthepromise.com/40439491 For more information or to discuss Health Care issues please feel free to contact me at Sbeck50659@aol.com
What these ads won’t tell you is that the information gathered comes voluntarily from the hospitals themselves and therefore cannot be trusted. Some will honestly report, others will not. I used Leapfrog and Hospital Compare in researching my top-rated hospital. However, Hospital acquired infection rates are not reported in most states and I had no idea that 271 patients a day die from infections they receive while treating for something else. I learned this when my two day stay turned into 2 months and the near amputation of my entire abdomen and left leg. I had contracted Man-eating Flesh Disease following my routine surgery. Despite repeated requests to the hospital’s administration and writing to Press Ganey & Associates (my hospital’s survey company)I was never granted the opportunity to fill out an official survey. I was further informed that only a random 30% of all patients ever receive a satisfaction/follow-up survey. If you are not selected “randomly” by the computer, you cannot be given one just because you ask. I no longer have faith in these “objective websites” the best thing to do is ask someone who has been in the facility you are going to and also, go there yourself. See if the floors are dirty and if patients yell into the hallway pleading, “excuse me, can you find me a nurse.” I’ve seen it happen. That will tell you more than any of these bogus compare sites. www.MySpace.com/AliciaTheWarrior
This system is designed to change hospital behavior. The average consumer can not navigage the complexities of the health care system like he or she would navigate ratings when purchasing a car, nor should they have to. The only way to improve care for all is to create payment reforms and incentives that reward good and safe patient care. Rating providers is a good and needed first step.
WSJ's Health Blog offers news and analysis on health and the business of health. The lead writer is Jacob Goldstein. He came to The Wall Street Journal from the Miami Herald, where he was a medical writer. Scott Hensley, who covered the drug industry as a reporter for the Journal for seven years, is the editor and also a contributor. The blog also includes contributions from other staffers at the Journal, WSJ.com and Dow Jones Newswires. Write to us at