5 reasons to take hospital ratings with a big grain of salt

5 reasons to take hospital ratings with a big grain of salt

It’s hospital ratings season in America, that time of year when marketing executives kick it into high gear to trumpet — and spin — the way their hospitals are graded by outside organizations.

This year, their workload has been especially heavy. In addition to annual rankings released Tuesday by U.S. News & World Report, the federal Centers for Medicare and Medicaid Services (CMS) just released its star-rating system for hospitals nationwide. While the ratings offer some valuable information to consumers, here’s why you shouldn’t put too much stock in the results.

No matter how objective the metrics, ratings are inherently subjective

The federal government and private organizations use a vast array of hospital data to break down their performance and boil it into easy-to-understand ratings for consumers. U.S. News & World report formulates its rankings by relying on a mix of physician surveys and data reported to trade groups and the federal government. CMS ratings are based solely on data hospitals are required to report to the agency.

The information itself may be objective, but which data points are used — and how they are weighted — can lead to contradictory conclusions. Consider the following:

Of US News & World Report’s’ top five hospitals,  only one  — Mayo Clinic — received a top, five-star rating from CMS. The rest — Cleveland Clinic, Massachusetts General Hospital, UCLA Medical Center, and Johns Hopkins — were not even in CMS’ top 100. (Johns Hopkins did not receive a rating from CMS because of incomplete data).

J.B. Silvers, a professor of health care finance at Case Western Reserve University, said the information, while boiled down into simple lists and stars, can be difficult for consumers to unpack, especially when hospitals are working behind the scenes to figure out ways to better their scores every year. “Some hospitals are better at working the numbers than others,” he said. “My guess is the safety net hospitals aren’t as good at it as richer hospitals.”

 

What can we expect in healthcare with Clinton, Trump?

http://thehill.com/blogs/congress-blog/healthcare/289527-what-can-we-expect-in-healthcare-now-that-clinton-and-trump

Now that our presidential nominees are set and the general election has begun, what do our nation’s hospitals and health systems need to do, whether Secretary Clinton or Mr. Trump is elected in November? They, and their parties, offer stark contrasts, but what will they mean for hospitals?

How Uber will Redefine Healthcare

http://altarum.org/health-policy-blog/how-uber-will-redefine-healthcare

UberUber

My Twitter pal and founding partner of Forthright Health Management, Tom Valenti, wrote in TechCrunch that “there will never be an Uber for healthcare” because “[h]ealthcare is not a transaction business; it is a relationship business.”

I’ll respectfully disagree: Healthcare “Ubers” are already proliferating and will ultimately reshape 21st-century medicine. The more aspects of healthcare we can shift from relationship to transaction, the better life will be for patients and doctors alike.

Health centers quickly filling up space in Philly area malls

http://www.philly.com/philly/business/retail/20160724_Mall_Medicine.html

How about treating yourself to a shopping spree after getting good news at your annual physical?

That opportunity has arrived, as more mall spaces are being used as medical offices and health centers to resuscitate struggling suburban malls.

Examples in the Philadelphia area include Main Line Health Center at Exton Square Mall, Suburban Health Center at Plymouth Meeting Mall, and the Center for Neurological and Neurodevelopmental Health (CNNH) at Voorhees Town Center.

Retail and real estate experts say the trend is on the rise, especially among malls looking to fill space vacated by traditional retailers with new tenants to generate rental income and increase traffic.

 

The top 8 takeaways from HFMA’s 2016 National Institute

http://www.beckershospitalreview.com/finance/the-top-8-takeaways-from-hfma-s-2016-national-institute.html

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When close to 5,000 healthcare professionals get together to talk numbers, it’s worth paying attention. The Healthcare Finance Management Association Annual National Institute took place in Las Vegas this week. Given the seismic changes in motion relative to the business model of hospitals and healthcare delivery networks, this is likely (and perhaps surprisingly) one of the more important and interesting conferences that will take place in healthcare this year.

In the $3 trillion market which is healthcare, roughly $1 trillion flows directly through hospitals. But the story isn’t what you think it is, as average operating margins are only 2 percent and inpatient volumes have been declining at a rate of close to 2 percent annually for the last few years. With margins that small, volume declining, and this much at stake, clearly the game is going to change in a big way. The bottom line is there is a truly stunning shift in focus taking place in finance, and that was evident at the HMFA conference this year.

This is a landscape view of some of the hot topics, but I think the bottom line is there has never been a better time for new ideas and true collaboration relative to solving healthcare’s most fundamental puzzle — figuring out how to deliver the best and most cost effective care possible to everyone, every day, in every community.

There is a line in a song from the musical Hamilton that says “Look around, look around, how lucky we are to be alive right now.” I think that captures the mindset we need from every stakeholder at the table right now. This is a great time to be in healthcare, perhaps the best.

The changing face of healthcare leadership

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/changing-face-healthcare-leadership?cfcache=true

Despite all the change health plans are facing today, there’s one key way of measuring leaders’ effectiveness that won’t change: Profitability.

Health plan executives will be evaluated based on the sustainability of their businesses during a time when profit margins are tight. They’ll also be measured based on their ability to retain employees and maintain current local relationships. Health plans will be investing in a lot of new talent. That means that leaders will be measured on their ability to grow their teams, while maintaining deep relationships in the communities where they’re doing business.

4 forces that will influence medical cost trends in 2017

http://www.healthcaredive.com/news/4-forces-that-will-influence-medical-cost-trends-in-2017/421162/

Binoculars

The healthcare industry is in a transformational period. The rising use of retail clinics, MACRA, population health efforts and the Medicare Part B demonstration are but a few examples of disruptive conversations being had in board rooms. Yet, all of these discussions are underscored by the one topic underlying most business conversations: the almighty dollar.

There’s a push and pull between healthcare services utilization and narrow networks focusing on value that could shift the medical cost growth rate in future years. “When medical growth outpaces general inflation, a flat trend is not good enough,” the report states.

“As a result, 2017 will be a tough balancing act for the health industry,” the report states, adding, “Healthcare organizations must simultaneously increase access to consumer friendly services while decreasing unit cost. Employers, worried that this current trend is at an inflection point that could turn back up, will demand more value from the health industry.”

A shifting definition of insurers at AHIP Institute

http://www.fiercehealthcare.com/payer/editor-s-corner-ahip-institute-reveals-shifting-definition-health-plans?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiWlRkbVlqUXpaREE1TURnMiIsInQiOiJwa1dNekJcL2p6Vk80ZzA2b2hsd3ByRFwvYjhOa0YxaXBFYTlkMTlkRjVjck42NjFXWWdwbWNoWGJ6QjNhSnFqMlBCbGFOMVlUXC9nZHVqa1FWMW1rMlpSWjd0VFJqYWVnOE05d2xuUGViMDBVMD0ifQ%3D%3D

Business people mingling at the 2016 AHIP conference

The line between payer and provider continues to blur. Not only are insurers increasingly working closely with providers, but more and more, they are acting like them—and vice versa. Just ask David Bernd, CEO emeritus of the integrated system Sentara Health, who pointed out that the historical “head-to-head combat” between the two entities no longer works in today’s health system. Similarly, as evidenced by the amount of time AHIP CEO Marilyn Tavenner spent lauding Medicaid managed care plans, care management—with a focus on the member as a whole person, not just a patient—is the future.

Office Chatter: Your Doctor Will See You In This Telemedicine Kiosk

http://khn.org/news/office-chatter-your-doctor-will-see-you-in-this-telemedicine-kiosk/?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=30825191&_hsenc=p2ANqtz-_oG-cDAgKBxBiJs8YX5ZvCHINTl7lijE2RT8UMQJMDNPF_TdjorRyDVQaxkLcFEC4mLeQGArwZb5WHVTXJpVJJNnllbA&_hsmi=30825191

Jessica Christianson uses a telemedicine kiosk at the Palm Beach County School District’s administrative building in West Palm Beach, Fla. A medical device called an otoscope connected to the kiosk lets nurse practitioner Stella Leviyeva in Miami examine the inside of Christianson’s ear. (Phil Galewitz/KHN)

Less than a decade ago, telemedicine was mainly used by hospitals and clinics for secure doctor-to-doctor consultations. But today, telemedicine has become a more common method for patients to receive routine care at home or wherever they are — often on their cellphones or personal computers.