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Hospital ratings and rankings in the era of big data

By Shane Wolverton

In today’s healthcare landscape, consumers often have access to more information on selecting a car than selecting a surgeon. A car purchase also typically involves comparison shopping to identify the vehicle that best meets the purchaser’s needs at the best price. And they have more ongoing protection – because major medical procedures, unlike cars, rarely come with guarantees.

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Existing physician recommendations – and occasional advice from family and friends – constitute the most common referral path for specialized in-patient or outpatient care. That path is often paved with assumptions and trust, at times questionable. Patients must have trust in the referring physicians’ knowledge about their medical condition, their judgment of the best specialist to provide treatment as well as their inter-physician relationships in the healthcare system.

Ratings and rankings systems abound
For patients who wish to play a greater role in managing their own healthcare, the hospital ranking and rating systems so ubiquitous today are widely used and can be valuable tools. Many of the names are familiar: U.S. News & World Report, Leapfrog, Healthgrades and even the government Centers for Medicare and Medicaid Services (CMS). With dramatically escalating healthcare costs, patients look to these systems to evaluate not only clinical quality, patient safety and performance but also healthcare value.

In the increasingly performance- and quality-driven healthcare age, are these systems truly as relevant and meaningful as they should be? Are they taking full advantage of today’s abundance of sophisticated quality measures and analytics? Or are they giving patients a false sense of security in their carefully researched decisions? Often consumers make choices based on the brand equity of ranking systems and are unaware of the integrity of the data that underlie the numbers.

First, a fundamental question: Why assume that these systems would evolve with the times to remain as relevant and meaningful as possible? Examining the ranking system’s intent is crucial. While certainly public service plays a role, some consumer rating and ranking systems exist primarily to fund the issuer’s other projects through sale of promotional programs to high-scoring facilities. Others are aimed at elevating healthcare transactions at top-rated client hospitals, while still others may be aimed at boosting magazine sales. In general, ratings may be accurate, but they are often not comprehensive enough to help patients make genuinely impactful decisions.

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