“Hospitals take (rating sites) very seriously and use them to figure out how to deliver better care,” said Kathleen Ciccone, HANYS' vice president of quality and research initiatives. “But unless there is some type of standardized approach with very transparent methodology, it's going to be very difficult for hospitals to really apply the ratings for the purposes of quality improvement.”
So HANYS created its own evaluation, called the “Report on Report Cards,” in which the association rated the raters on a scale of zero to three stars. HANYS gave the Joint Commission's Quality Check and the CMS' Hospital Compare the highest rating of three stars. The Truven Health Analytics 100 Top Hospitals, Healthgrades' America's Best Hospitals and Consumer Report's Hospital Safety Ratings received one star. U.S. News & World Report's Best Hospitals received a half star.
The ratings groups argue, however, that HANYS has an obvious conflict of interest in rating the raters and that it was not transparent about its own methodology.
Representatives of Truven, U.S. News and Healthgrades dismissed their low ratings from HANYS, saying the association's report card did not take account of their unique goals.
Truven focuses on helping hospital leaders reach actionable benchmarks, said Jean Chenoweth, Truven's senior vice president of performance improvement.
U.S. News evaluates hospitals on whether they excel in treating the most medically challenging patients, said Ben Harder, director of healthcare analysis for U.S. News.
Healthgrades chief strategy officer Evan Marks said there are dramatic differences between groups that provide performance data like complications, those that weight those measures by assigning a score, and those that give out awards or recognitions. “You can't put them all in the same bucket,” Marks said. “We don't issue a grade, we provide data.”
Consumer Reports' Santa said it's hypocritical for hospitals to complain about ratings groups when they often use favorable rankings in their marketing and advertising or make claims about having the “best doctors” or “the most innovative technology” without good evidence.
“I chuckle when I get reports that hospital CEOs are worried or confused about ratings,” Santa said. “They're not so confused that they are not using comparisons in their own advertising.”
Hospital leaders will have to accept that consumers are starting to scrutinize healthcare the same way they look at other products and services, said Leah Binder, president and CEO of the Leapfrog Group. “Consumers are accustomed to reviewing a lot of reviewers and coming to their own conclusions,” she said. “Hospitals shouldn't be exempt.”