Hospital Quality

While information about health plan performance has been available to consumers for nearly a decade, similar data about hospitals in New York has not been easy to access.  Only recently have New Yorkers been able to obtain details about quality of care provided in hospital settings, as a result of several important efforts to provide this vital information.

The Alliance for Quality Health Care (AQHC), a collation of businesses, consumer education groups and health plans, in 2003 released the first ever statewide hospital report card designed to allow consumers to compare more than 200 hospitals across New York.  Updated report cards are released each year.  The report is available at www.myHealthFinder.com.

The New York Health Plan Association is a member of AQHC and supports efforts to get quality data to the public.  The AQHC report card is the latest and one of the most comprehensive efforts in a national trend to help health care consumers find the most experienced and skilled hospitals by using uniform quality indicators, based on recently released federal government standards from the Agency for Health Care Quality and Research.  The indicators include mortality rates for certain conditions and procedures, hospital-level procedure utilization rates and volumes of procedures. In addition to helping consumers make decisions about their care, such information is useful to hospitals to identify areas in need of improvement.

The New York State Department of Health (DOH) recently launched a Web-based resource providing quality measures for the state’s 239 hospitals.  The site allows consumers to review hospital data by health condition, surgical procedure or special state designation (i.e., stroke or burn center).  It also includes information on four health conditions — care related to heart attacks, heart failure, pneumonia and prevention of surgical infections — and up to 20 related services, as well as risk-adjusted surgical outcomes on several procedures. DOH also collects other information about hospitals that is focused on particular types of procedures performed such as Coronary Artery Bypass Surgery.  In addition, the department collects inpatient and outpatient data from all hospitals in the state.  These data, compiled by the Statewide Planning and Research Cooperative System (SPARCS), provide a management tool that assists hospitals, agencies, and health care organizations in making decisions regarding financial planning and monitoring of inpatient and ambulatory surgery services and costs.  DOH also collects data about patient-related adverse events occurring in hospital settings. Known as the New York Patient Occurrence Reporting and Tracking System (NYPORTS), this information is intended to be used in conjunction with the quality assurance process in a hospital and to help improve patient care.  All of this hospital-related information is available at www.health.state.ny.us.

The Centers for Medicare and Medicaid Services (CMS) in 2005 began a pilot project making hospital quality data available to consumers.  Hospitals voluntarily report certain data to CMS, which publish the data on its Web site. The report initially focuses on 10 performance measures to gauge the use of best practices when treating three common but serious conditions-heart attack, heart failure and pneumonia.  The CMS effort, first piloted in several states including New York, also uses a standardized survey to compare patients´ experiences at different hospitals.  The New York State Health Accountability Foundation (NYSHAF), a public-private partnership dedicated to promoting value-based health care purchasing, is developing a New York hospital report card.

Individual health plans have also begun developing hospital report cards for their members and other consumers.  Among the efforts today, MVP Health Care, a Schenectady-based plan, recently posted a Web-based hospital report care that its members and providers can use to evaluate quality of care being delivered at the hospitals in the plan´s network.  Similarly, Excellus Inc., a Rochester-based health insurer, is providing consumers with its own Web-based tool to allow consumers to compare upstate hospitals´ performance in treating specific ailments and performing specific procedures.  The data, which is only available for hospitals in portions of the counties served by Excellus, is based on the same data used by the AQHC effort. 

Other websites offering consumers information about hospitals include:
Health Care Choices - a New York not-for-profit corporation dedicated to educating the public about the nation´s health care system.
Center for Medical Consumers - a non-profit advocacy organization active in statewide and national efforts to improve the quality of health care.

New York Health Plan Association, 90 State St. Suite 825, Albany, NY 12207 ph: 518.462.2293 fax: 518.462.2150
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