Hospital, HMO Ratings ‘Open’ to Public

People in New York no longer have to wonder if their local hospital is
worse than others, or if they’re paying too much for their health care.

The New York State Health Accountability Foundation (NYSHAF) today released
an interactive report on the performance of the state’s health plans and hospitals.

Funded by a $60,000 New York State grant and built using open source technology, including
FreeBSD, Apache, MySQL and PHP, the scorecard provides data on the quality, volume, length of stay and pricing of care provided by the state’s health insurers and hospitals, searchable by county.

Consumers and employers can use the site to search within each county,
compare the performance of the county’s HMOs and hospitals across a range of
health conditions and procedures, and contrast this performance with state
and national averages.

Consumers and employers can also view each hospital’s and HMO’s individual performance on all quality, financial and utilization
measures –- including HMO premiums and average “list” charges, Medicaid
reimbursement and length of stay for hospitals.

For the HMOs, the site includes 26 measures of quality care grouped within the categories of Behavioral Health, Medical Care/Chronic Illness, Medical Care/General, Patient Experience and Women’s Health.

Hospital performance is
reported for 18 measures across the categories Heart Attack, Heart Failure,
Pneumonia and Surgical Infection Prevention.

The report card provides each
New York hospital’s Medicaid reimbursement rate, length of stay and average
“self-pay” charge for each of 15 common diagnoses and procedures. Each
commercial insurer’s individual and family premium for a standardized HMO
plan is also published.

Anthony Shih, vice president of quality improvement for IPRO, which produced
the scorecard, said that a principal purpose of the tool is “to start
stimulating a dialog about health care efficiency.”

Unlike with other types of purchase decisions, he said, people tend
to focus on quality of care to the exclusion of price.

“The key is finding a balance between cost and quality, and health care
hasn’t been like that yet, continued Shih. “Our ultimate goal is to provide a way to present quality and financial
information in a manner that describes each hospital’s and HMO’s
efficiency.”

NYSHAF is a private-public partnership dedicated to promoting transparency
in the health care system, and was founded by IPRO and the New York Business
Group on Health, and is directed by an Advisory Council of major New York
employers.

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