Truven investigated hospital performance on a single Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey question: Would you recommend this hospital to your family and friends? Smaller teaching hospitals had the highest score, on average, among the five classes, while medium-sized community hospitals scored the lowest.
Ted Townsend, president and CEO of 363-bed UnityPoint Health-St. Luke's Hospital in Cedar Rapids, Iowa, reads the Truven analysis as good news for smaller teaching hospitals, which outperform major teaching hospitals on every quality and cost metric in the study.
That means smaller teaching hospitals could have a natural advantage under the CMS' value-based purchasing formula, which ties payment rates to quality, cost and patient experience measures.
“We have some education going on, but a far greater degree of experience at the bedside on a day-in, day-out basis,” he says. “And that's the sweet spot from a cost standpoint as well, because we don't have to have all the infrastructure of a major academic medical center, but we do have a lot of the value that comes from teaching people.”
The University of Michigan Hospitals & Health Centers has been named to the 100 Top Hospitals list eight times, and Bahl agrees that the Truven analysis might provide hints about how major teaching hospitals are likely to fare under the government's value-based purchasing program. Although Truven's analysis shows that major teaching hospitals perform relatively well on the one willingness-to-recommend HCAHPS measure, academic medical centers generally tend to score lower than other hospital classes on the full HCAHPS survey, Bahl says. Further, the Truven analysis shows that major teaching hospitals had no advantage over other classes in terms of core-measure performance.
“In value-based purchasing, where even small differences in measurement results can translate to large differences in overall program performance, major teaching hospitals may not thrive, but they can be competitive,” Bahl says.