NCPA - National Center for Policy Analysis

Medicare Hospital Quality Reporting Brings Little or No Mortality Improvement

March 7, 2012

Medicare's seven-year public reporting initiative for hospitals, Hospital Compare, had no impact on reducing death rates for two key health conditions and just a modest effect on a third, according to a new study in Health Affairs.  The study raises questions about the initiative's ability to improve the quality of care provided by the nation's hospitals.

  • The study showed that Hospital Compare produced no reductions beyond the existing trends in improvement of care of heart attacks and pneumonia.
  • Authors found that hospitals might have improved on 30-day mortality rates during the study, but attribute the change to ongoing innovations in clinical care -- and not to any effect related to public reporting.
  • At the same time, the researchers found a modest improvement in mortality rates for heart failure -- but, they cannot prove that this was related to the public reporting initiative.

The findings help inform the ongoing debate about Hospital Compare, whose measures, critics say, do not necessarily reflect quality of care provided at hospitals.  Study authors say this is one of the strongest studies to suggest that Medicare's public reporting effort made little or no impact on quality --at least using the current set of metrics.

Hospital Compare was created to help Medicare patients rank or judge hospitals and other health care providers based on standards of care.  Past surveys have suggested that quality report cards like Hospital Compare are underused by patients and ignored by referring physicians.  This study adds to that evidence, suggesting that consumers at least did not seem to be checking the Medicare website to make more informed choices about where to check in for an elective procedure.

Source: Chris Fleming, "Medicare Hospital Quality Reporting Brings Little or No Mortality Improvement," Health Affairs, March 6, 2012. Andrew M. Ryan, Brahmajee K. Nallamothu and Justin B. Dimick, "Medicare's Public Reporting Initiative on Hospital Quality Had Modest or No Impact on Mortality from Three Key Conditions," Health Affairs, March 6, 2012.

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