Grading Healthcare

In a December 11th Tulsa World article, Bixby School Superintendent Rob Miller suggested, and then provided a number of ways, physicians and other healthcare facilities could be graded A through F, much like we do for our schools and students.

The good news is that hospitals (and some outpatient ambulatory surgery centers [ASCs]) are indeed already graded A-F. The not so good news: many people are not aware those grades exist. And even with knowledge and access, we generally follow our doctor’s recommendation instead of looking for alternatives using available safety data. The current information doesn’t give us everything we need to make optimal healthcare decisions — but it’s a start.

Where would you look to find hospital safety metrics and A to F grades? The Leapfrog Group, a non-profit started in 2000 by employers that purchase healthcare. Leapfrog serves hospital and ASC safety and transparency in two ways:

  • They conduct a voluntary survey of general hospitals in the United States each year. Over 2100 hospitals participate. (ASC surveys are just beginning).
  • Leapfrog also uses publicly available data, (reported by hospitals to CMS), to create a Hospital Safety Grade for over 4,500 general hospitals in the US. This grading is NOT voluntary and can inform healthcare purchasers and consumers how likely certain complications are to occur in hospital patients. There are 30 metrics in this grade, including blood clots, infections, surgical instruments left behind and more. These A to F grades, issued each Spring and Fall, are easy to find [] This is what Superintendent Miller was suggesting.

WellOK, The Oklahoma Business Coalition on Health, is the official Regional Leader for Leapfrog in NE Oklahoma. In the seven years of our work, we’ve gone from one hospital participating in the survey to over a dozen hospitals participating, making both quality of care and cost of care transparent. With the exception of one large hospital system, the other big systems, and many small hospitals in Northeast Oklahoma work with Leapfrog on the voluntary Hospital Survey.

This is a big commitment, requiring a deep dive into quality and safety measures within a hospital. Hospitals then use their results to target improvements. Survey results are open to everyone on the Leapfrog website. []

None of these quality ratings is infallible, but as consumers, we can use the available ratings to inform our healthcare decisions. At present, we can’t get to measurements as specific as determining which doctor has patients with diabetes living the longest with fewest complications. But we can see which hospitals have the highest infection rates and make a better choice when hospital care is needed.

One more important point: Healthcare determines only part of a person’s overall health. “Social Determinants of Health” play an even bigger role. These include economic stability; neighborhood and environment; access to physicians and clinics; education and health literacy; and social and community context. Social determinants woefully undermine health, especially in rural Oklahoma.

So, to answer Mr. Miller’s plea for a standardized grading system: yes, those grades are available. As a purchaser of healthcare for employees and families on your health plan, you can take a proactive stance. The information you need is out there to allow you to identify the best providers. At present, it won’t find you; you must seek it out. Start with Leapfrog.