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IBM Watson names 100 top hospitals

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https://www.prnewswire.com/news-releases/ibm-watson-health-announces-100-top-hospitals-300805633.html

https://www.beckershospitalreview.com/rankings-and-ratings/ibm-watson-names-100-top-hospitals.html

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2019 Study Finds Top-Performing U.S. Hospitals Provide Better Care at Lower Cost and Higher Profit Margins than Peers Evaluated in the Study

ARMONK, N.Y., March 4, 2019 /PRNewswire/ — IBM Watson Health™ (NYSE: IBM) today published its 100 Top Hospitals® annual study identifying top–performing hospitals in the U.S. This study spotlights the best–performing hospitals in the U.S. based on a balanced scorecard using publicly available data for clinical, operational, and patient satisfaction metrics. The study is part of IBM Watson Health’s commitment to leveraging science and data to advance health and it has been conducted annually since 1993.

Overall, the Watson Health 100 Top Hospitals® study found that the top-performing hospitals in the country achieved better risk-adjusted outcomes while maintaining both a lower average cost per patient and higher profit margin than peer group hospitals that were part of the study.

“At a time when research shows that the U.S. spends nearly twice as much on healthcare as other high-income countries, yet has less effective population health outcomes1, the 100 Top Hospitals are setting a different example by delivering consistently better care at a lower cost,” said Ekta Punwani, 100 Top Hospitals® program leader at IBM Watson Health.

Kyu Rhee, M.D., M.P.P., vice president and chief health officer at IBM Watson Health, added: “From small community hospitals to major teaching hospitals, these diverse hospitals have demonstrated that quality care, higher patient satisfaction, and operational efficiency can be achieved together. In this era of big data, analytics, transparency, and patient empowerment, it is essential that we learn from these leading hospitals and work to spread their best practices to our entire health system which could translate into over 100K more lives saved, nearly 40K less complications, over 150K fewer readmissions, and over $8 billion in savings.”

Following were the key performance measurements on which 100 Top Hospitals showed the most significant average outperformance versus non-winning peer group hospitals (full study results available here):

  • Higher Survival Rates: The 100 Top Hospitals winners achieved survival rates that were 24.9 percent higher than those of peer hospitals.
  • Fewer Complications and Infections: Patients at winning hospitals experienced 18.7 percent fewer complications and 19.3 percent fewer healthcare-associated infections than peer group hospitals.
  • Shorter Length of Stay: Winning hospitals had a median severity-adjusted length of stay that was one half-day shorter (0.5) than peers.
  • Shorter Emergency Department Wait Times: Overall, winning hospitals delivered median emergency department wait times that were 17.3 minutes shorter than those of peer group hospitals.
  • Lower Inpatient Expenses: Average inpatient costs per discharge were 11.9 percent lower (a difference of $830 per discharge) at 100 Top Hospitals versus peer group hospitals.
  • Higher Profit Overall Margins: Winning hospitals maintained a median operating profit margin that was 11.9 percentage points higher than peer group hospitals.
  • Higher Patient Satisfaction: Overall hospital experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), was rated 3 percent higher for winning hospitals than peer group hospitals.

The IBM Watson Health 100 Top Hospitals winners outperformed peer group hospitals within all 10 clinical and operational performance benchmarks evaluated in the study: risk-adjusted inpatient mortality index, risk-adjusted complications index, mean healthcare-associated infection index, mean 30-day risk-adjusted mortality rate, mean 30-day risk-adjusted readmission rate, severity-adjusted length of stay, mean emergency department throughput, case mix- and wage-adjusted inpatient expense per discharge, adjusted operating profit margin, and HCAHPS score.

Extrapolating the results of this year’s study, if all Medicare inpatients received the same level of care as those treated in the award-winning facilities:

  • More than 103,000 additional lives could be saved;
  • More than 38,000 additional patients could be complication-free;
  • More than $8.2 billion in inpatient costs could be saved; and
  • Approximately 155,000 fewer discharged patients would be readmitted within 30 days.

In addition to the 100 Top Hospitals, the IBM Watson Health study also recognizes the 100 Top Hospitals Everest Award winners. These are hospitals that earned the 100 Top Hospitals designation and also are among the 100 top for rate of improvement during a five-year period. This year, there are 15 Everest Award winners.

To conduct the 100 Top Hospitals study, IBM Watson Health researchers evaluated 3,156 short-term, acute care, non-federal U.S. hospitals. All research was based on the following public data sets: Medicare cost reports, Medicare Provider Analysis and Review (MEDPAR) data, and core measures and patient satisfaction data from the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website. Hospitals do not apply for awards, and winners do not pay to market this honor.

For more information, visit www.100tophospitals.com.

Here are the winning hospitals, by category, with asterisks indicating the Everest Award winners:

Major Teaching Hospitals

Advocate Illinois Masonic Medical Center – Chicago, IL
Ascension Providence Hospital  – Southfield, MI
Banner – University Medical Center Phoenix – Phoenix, AZ
Cedars-Sinai Medical Center – Los Angeles, CA
Garden City Hospital – Garden City, MI*
Mayo Clinic Hospital – Jacksonville, FL
Mount Sinai Medical Center – Miami Beach, FL
NorthShore University HealthSystem – Evanston, IL
Saint Francis Hospital and Medical Center – Hartford, CT
Spectrum Health Hospitals – Grand Rapids, MI
St. Joseph Mercy Hospital – Ann Arbor, MI*
St. Luke’s University Hospital – Bethlehem – Bethlehem, PA
The Miriam Hospital – Providence, RI
UCHealth University of Colorado Hospital – Aurora, CO*
University of Utah Hospital – Salt Lake City, UT

Teaching Hospitals

Abbott Northwestern Hospital – Minneapolis, MN
Aspirus Wausau Hospital – Wausau, WI
Brandon Regional Hospital – Brandon, FL
BSA Health System – Amarillo, TX
CHRISTUS St. Michael Health System – Texarkana, TX*
Good Samaritan Hospital – Cincinnati, OH
Lakeland Medical Center – St. Joseph, MI
Mercy Hospital St. Louis – St. Louis, MO
Monmouth Medical Center – Long Branch, NJ
Morton Plant Hospital – Clearwater, FL
Mount Carmel St. Ann’s – Westerville, OH
Park Nicollet Methodist Hospital – St. Louis Park, MN
Parkview Regional Medical Center – Fort Wayne, IN*
PIH Health Hospital – Whittier – Whittier, CA
Riverside Medical Center – Kankakee, IL
Rose Medical Center – Denver, CO*
Sentara Leigh Hospital – Norfolk, VA*
Sky Ridge Medical Center – Lone Tree, CO
SSM Health St. Mary’s Hospital – Madison – Madison, WI
St. Luke’s Hospital – Cedar Rapids, IA
St. Mark’s Hospital – Salt Lake City, UT*
Sycamore Medical Center – Miamisburg, OH
UCHealth Poudre Valley Hospital – Fort Collins, CO
Utah Valley Hospital – Provo, UT*
West Penn Hospital – Pittsburgh, PA

Large Community Hospitals

Advocate Sherman Hospital – Elgin, IL*
Banner Del E. Webb Medical Center – Sun City West, AZ
Baylor Scott & White Medical Center – Grapevine – Grapevine, TX
Hoag Hospital Newport Beach – Newport Beach, CA
IU Health Bloomington Hospital – Bloomington, IN*
Mease Countryside Hospital – Safety Harbor, FL
Memorial Hermann Memorial City Medical Center – Houston, TX
Mercy Health – Anderson Hospital – Cincinnati, OH
Mercy Health – St. Rita’s Medical Center – Lima, OH
Mercy Hospital  – Coon Rapids, MN
Mercy Hospital Oklahoma City – Oklahoma City, OK
Northwestern Medicine Central DuPage Hospital – Winfield, IL
Sarasota Memorial Hospital – Sarasota, FL
Scripps Memorial Hospital La Jolla – La Jolla, CA
St. Clair Hospital – Pittsburgh, PA
St. David’s Medical Center – Austin, TX
St. Joseph’s Hospital – Tampa, FL*
Texas Health Harris Methodist Hospital Southwest Fort Worth – Fort Worth, TX
University of Maryland St. Joseph Medical Center – Towson, MD
WellStar West Georgia Medical Center – LaGrange, GA

Medium Community Hospitals

AdventHealth Wesley Chapel – Wesley Chapel, FL
Dupont Hospital – Fort Wayne, IN
East Cooper Medical Center – Mt. Pleasant, SC
East Liverpool City Hospital – East Liverpool, OH*
Garden Grove Hospital Medical Center  – Garden Grove, CA
IU Health North Hospital – Carmel, IN
IU Health West Hospital – Avon, IN
Logan Regional Hospital – Logan, UT
Memorial Hermann Katy Hospital – Katy, TX
Mercy Health – Clermont Hospital – Batavia, OH
Mercy Hospital Northwest Arkansas – Rogers, AR
Mercy Medical Center – Cedar Rapids, IA
Montclair Hospital Medical Center – Montclair, CA
Mountain View Hospital – Payson, UT
Northwest Medicine Delnor Hospital – Geneva, IL
St. Luke’s Anderson Campus – Easton, PA
St. Vincent’s Medical Center Clay County – Middleburg, FL
UCHealth Medical Center of the Rockies – Loveland, CO
West Valley Medical Center – Caldwell, ID
Wooster Community Hospital – Wooster, OH

Small Community Hospitals

Alta View Hospital – Sandy, UT
Aurora Medical Center – Two Rivers, WI
Brigham City Community Hospital – Brigham City, UT
Buffalo Hospital – Buffalo, MN
Cedar City Hospital – Cedar City, UT
Hill Country Memorial Hospital – Fredericksburg, TX
Lakeview Hospital – Bountiful, UT
Lone Peak Hospital – Draper, UT
Marshfield Medical Center – Rice Lake, WI
Nanticoke Memorial Hospital – Seaford, DE
Parkview Noble Hospital – Kendallville, IN
Parkview Whitley Hospital – Columbia City, IN*
Piedmont Mountainside Hospital – Jasper, GA
San Dimas Community Hospital – San Dimas, CA
Seton Medical Center Harker Heights – Harker Heights, TX
Southern Tennessee Regional Health System – Lawrenceburg, TN
Spectrum Health Zeeland Community Hospital – Zeeland, MI
St. John Owasso Hospital – Owasso, OK
St. Luke’s Hospital – Quakertown – Quakertown, PA
Stillwater Medical Center – Stillwater, OK*

 

 

Teaching Hospitals Cost More, but Could Save Your Life

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Teaching Hospitals Cost More, but Could Save Your Life

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Perhaps not evident to many patients, there are two kinds of hospitals — teaching and nonteaching — and a raging debate about which is better. Teaching hospitals, affiliated with medical schools, are the training grounds for the next generation of physicians. They cost more. The debate is over whether their increased cost is accompanied by better patient outcomes.

Teaching hospitals cost taxpayers more in part because Medicare pays them more, to compensate them for their educational mission. They also tend to command higher prices in the commercial market because the medical-school affiliation enhances their brand. Their higher prices could even cost patients more, if they are paying out of pocket.

To save money, insurers have started establishing hospital networks, and policy makers are considering ways to steer patients away from teaching hospitals. Those efforts may well save patients and taxpayers money. But how will that affect the quality of care?

One answer is provided in a new study of over 21 million hospital visits paid for by Medicare in 2012 and 2013. Teaching hospitals save lives. For every 83 elderly patients seen by a major teaching hospital, one more is alive 30 days after discharge than if those patients had been admitted to a nonteaching hospital. This is a large mortality effect.

“It’s about half the size of a breakthrough medical therapy like stenting for heart-attack patients,” said Amitabh Chandra, an economist with the Harvard Kennedy School and a longtime skeptic of the value of teaching hospitals, who wasn’t involved in this study.

“Minor” teaching hospitals — which also have educational missions but are not members of the Council of Teaching Hospitals and Health Systems — also outperformed nonteaching hospitals, but by a smaller margin.

The study, published in the Journal of the American Medical Association, adjusted for other factors that could have skewed the results, like demographics, patients’ diagnoses, hospital size and profit status. Because mortality rates differ geographically, it compared teaching with nonteaching hospitals within the same state. Even after such adjustments, it found mortality rates are lower at teaching hospitals for 11 of 15 common medical conditions and five of six major surgical conditions. The more doctors in training per bed a hospital had, the lower its mortality rate.

Given the importance of this issue, you’d think we would already know the mortality differences between teaching and nonteaching hospitals. But the seminal studies on the subject are based on data at least two decades old. Other, more recent studies focus on only a few types of patients or offer conflicting results.

“We thought the comparative performance of teaching and nonteaching hospitals was worth a fresh look because medicine has changed considerably since those older studies,” said Laura Burke, the lead author on the study and an emergency physician with the Harvard T.H. Chan School of Public Health. “And the more recent studies don’t settle the question.” (I am a co-author on the study, along with Dr. Burke and other Harvard colleagues Dhruv Khullar, E. John Orav and Ashish Jha. Dr. Khullar is also an Upshot contributor.) The study was funded by the American Association of Medical Colleges, which had no editorial control over analysis or publication.

Though the study revealed mortality differences by teaching status, it could not illuminate the cause of those differences. Perhaps teaching hospitals attract higher-quality practitioners, more closely follow best practices, or use medical technology more effectively.

Other studies suggest teaching hospitals do not offer higher quality more broadly. For example, an analysis led by Jose Figueroa, a physician with the Harvard T.H. Chan School of Public Health, found that teaching hospitals were more likely to be penalized by Medicare for low quality compared with nonteaching hospitals. Another study found teaching hospitals were more likely to be penalized for higher hospital readmission rates.

An examination of Massachusetts hospitals found comparable quality performance at teaching and nonteaching hospitals. The state has a goal — codified in a 2012 state law — of bringing health care spending growth in line with overall economic growth. The Massachusetts Health Policy Commission has highlighted the high costs of teaching hospitals as part of this effort.

The new study did not assess the cost of the benefits in mortality that teaching hospitals deliver.

“The typical teaching hospital is at least 30 percent more expensive,” Mr. Chandra said. “Is 1 percent fewer deaths worth that price?” It’s a question few like to ask, but spending more on hospital care means less for other things we value — and that are known to improve health and welfare, too — like education and nutrition programs.

About 26 percent of hospitals are teaching hospitals, accounting for just over half of all admissions. Unsure which hospitals in your area are teaching hospitals? It’s something most of them make a point of mentioning, so you can often find a hospital’s teaching status on its website. If not, an inquiry to the hospital should settle the matter. If you use one, the cost of your care will be higher, but it might save your life.

Hospitals say they subsidize graduate medical education, but cost-benefit unknown

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http://www.crainsdetroit.com/article/20150719/NEWS/307199997/hospitals-say-they-subsidize-graduate-medical-education-but-cos

http://www.fiercehealthfinance.com/story/do-teaching-hospitals-profit-graduate-medical-education/2015-07-20?utm_medium=nl&utm_source=internal