For the past two years, WellOK has partnered with Quantros, Inc. to make sense of publicly available quality and safety data. Quantros puts a front end on the rich trove of data that hospitals must report to Centers for Medicare Medicaid Services.
Our subscription to Quantros allows our Director of Quality Initiatives, Susan Driesel RN CPC, to extract quality results for 28 major surgical and medical conditions. Examples include: gallbladder removal; spinal fusion; joint replacement; cardiac care; heart bypass and valve replacement.
Two questions we get frequently: why not just rely on your physician to help refer you to the best place? Why not just go by best reputation or the real-life experience of friends and family?
First, your physician may not know the quality score for particular services at all our regional and state hospitals. Most don't. Physicians who are employed often refer to specialists and hospitals in their own health systems — and in many instances are expected to do so. Those referral patterns don't take quality into account.
Second, no hospital does everything well. One anecdote: Stan Schwartz recently reviewed claims on a spinal fusion operation done at a renowned Eastern hospital with a great reputation and on certain “top ten” hospital lists again this year. It is a great hospital, but if you need spinal fusion, you might elect to go elsewhere: For spinal fusion, their score was at the very low end of the rating scale.
Our Hospital Guide clearly illustrates that certain hospitals in our region are great at certain things but not necessarily all things.
The guide is updated about every quarter as new data become available. As of this date, data are current through 2018Q3.
Several caveats: these ratings are based on care reported to CMS. For that reason, patients on commercial coverage, who are generally younger, may be underrepresented. Also, be careful about extrapolating from one procedure to another. Because s surgeon and hopsital are skilled at joint replacement, they are not necessarily as good at, say, joint arthroscopy surgery.
The Hospital Guide is in our Members Only section and requires a registration and password for access. If you are employed by one of our WellOK member organizations (here), email us at firstname.lastname@example.org and request a registration.