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Yelp, Google and…Medicare

What will Yelp, Google and Medicare soon have in common? Star ratings.

“One option we have considered is aggregating measures in a graphical display, such as star ratings,” states Medicare’s Federal Register of proposed rules release. Set to go in effect on October 1, this simple statement buried in a fine-print 339-page release has already set off a firestorm of speculation and a strongly worded response from the American Association of Medical Colleges:

“The AAMC strongly opposes the use of a star rating system, which may make inappropriate distinctions for hospitals whose performance is not statistically different.”

While there are already dozens of quality measures already listed on Medicare’s Hospital Compare website, they are rather difficult to sort through and not clearly useful. For example, if your grandmother was having chest pain and you had to take her to a nearby hospital, would you choose it based on the frequency of readmissions, timeliness of care, cleanliness of the facility, frequency of accidentally punctured lungs or some other metric?

When I enter my zip code, the two closest hospitals populate: The recently acquired/renamed Brigham Women’s Faulkner Hospital and the Brigham Women’s Hospital. Two fine institutions both likely to receive the highest overall star rating. However, while the BWH Faulkner hospital is significantly closer and would seem like the appropriate choice, 81 percent of patients gave BWH a 9 or 10 rating out of 10, compared to only 74 percent of Faulkner patients. However, if surgical treatment would be needed, the Faulkner hospital shows the same rate of “serious complications” as the national average while the Brigham has a “Worse than U.S. National Rate” listing.

The point is, when choosing a hospital, patients don’t know what type of treatment is needed. They just need treatment, and they need it to be soon, (cost)-effective and safe. While admittedly glossing over the fine and varied details of medical care, star ratings accomplish the goal of conveying the overall quality of an institution in an easy-to-understand and quickly digestible manner.

Rather than opposing a star rating system, I would encourage my colleagues at the American Association of Medical Colleges to embrace a patient-friendly system for hospital ratings. On our physician review system that integrates with Google reviews, we have found consistently that patients are eager to choose primary care physicians, specialists, chiropractors and cosmetic treatments based on Google stars and reviews. In fact, with an ever-increasing volume of searches from mobile devices, more and more patients are choosing their PCP or specialist from their smartphone. It only makes sense for the same system to be available for hospital comparison.

While the initial Medicare star rating system will undoubtedly emphasize certain types of quality care more than others, subsequently cause uproar and a temporary and shortsighted drive by hospitals to improve certain quality metrics, over time it will be revised and improved to more closely resemble the type and quality of care received.


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Mystic Maggie

All of the Mystic Maggie Posts are RSS Reader Feeds from around the web. All copyright remains with the original publisher. No copyright is claimed or intended. Where supplied, links back to the original article are included.

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