Two years ago, at a summit on hospital rankings in New York co-hosted by U.S. News, we announced our intent to expand our public reporting on hospital quality to include routine conditions and procedures, and the following day we provided details. We have moved ahead as planned, and next spring the first phase of the new initiative, with the working name Best Hospitals for Routine Care, will be launched. What will it be? How will it look? In the following FAQ overview, we try to anticipate questions.
What will U.S. News publish? U.S. News will evaluate each hospital's performance in various high-volume procedures and conditions. A hospital may be rated High Performing, Average or Below Average in a given procedure or condition. Hospitals with insufficient data will not be rated. These would include hospitals with fewer than 25 cases over three years, for example.
Initially U.S. News will publish ratings, based largely on analysis of administrative data, on five cohorts of Medicare inpatients admitted from 2010 through 2012:
- Those who had uncomplicated coronary artery bypass graft (CABG) surgery.
- Those who had total hip replacement (THR).
- Those who had total knee replacement (TKR).
- Those admitted with a diagnosis of congestive heart failure (CHF).
- Those admitted with a diagnosis of chronic obstructive pulmonary disease (COPD).
Along with each hospital rating, we will publish an array of related quality indicators for each hospital. For example, for each hospital rated in CABG, we will report data on the hospital’s mortality rate, readmissions rate and other measures for CABG patients. The hospital’s overall rating in CABG will be calculated using a composite of these CABG quality indicators.
Who will have access to the U.S. News ratings? Everyone. The ratings will be freely available on usnews.com, enabling all health care consumers to use Best Hospitals for Routine Care as a decision support tool when they select a provider.
Who should rely on the ratings? No one should rely exclusively on these ratings, or any ratings, when making health care decisions. They offer a useful starting point for comparing hospitals. The forthcoming ratings are based on the experience of patients age 65 or older facing hospitalization for one of the procedures or conditions covered by the ratings.
Which hospital will be No. 1? None. Best Hospitals for Routine Care will not feature numerical rankings. The best hospitals will be rated High Performing.
What measures will U.S. News use to rate hospitals? The methodology behind Best Hospitals for Routine Care is based primarily on outcomes measures. These include mortality, readmissions, health care-associated infections and other widely used measures of hospital quality. Measures will be risk-adjusted to the greatest extent possible within the limitations of the data available to us. Hospital reputation will not be a factor in the forthcoming ratings.
Will the new ratings affect the Best Hospitals rankings or Best Hospitals Honor Roll? We have no plans to incorporate results from Best Hospitals for Routine Care into our existing Best Hospitals methodology, nor will a hospital's Best Hospitals rank (or lack of rank) affect its ratings in routine care. Best Hospitals is a separate project with a different objective. Specifically, the Best Hospitals rankings are designed to guide consumers who need a particularly high level of care because of a rare or complex diagnosis or need for a particularly difficult or risky procedure. By contrast, Best Hospitals for Routine Care focuses on less-demanding care of the kind more often received by Medicare patients. Consequently, U.S. News has developed separate and distinct methodologies for each of these projects.
When will U.S. News publish these ratings? Most likely in April or May. U.S. News has not yet determined the release date. Registered users of the free Best Hospitals Dashboard will receive more information on the timing of the release as soon as it becomes available.
[Read: Introducing the Best Hospitals Dashboard ]
How can I learn more? Registered users of the Best Hospitals Dashboard can now access additional material about Best Hospitals for Routine Care, including an introductory video and a set of slides that outline the methodology. A preliminary methodology report will be available soon.
Hospital representatives who are unregistered can submit a request for a Dashboard account. Other professionals involved in quality measurement and public reporting, such as staff of hospital associations and specialty societies, will be able to register for the Dashboard soon. In the spring, embargoed ratings will be available to Dashboard users before they are released to the public.
There is no cost associated with registering for or using the Dashboard. U.S. News staff will review each application, and has sole discretion to accept or decline.
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