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Medicare News
Hospital Death Rates for Heart Attack, Failure in
Medicare Patients to be Published by CMS
Centers for Medicare & Medicaid Services provides
seniors 'Hospital Compare'
May 24, 2007 -
CMS in
June will post the first broad comparison of hospital mortality rates
for heart attack and heart failure in Medicare beneficiaries on the
Hospital Compare
Web site,
USA Today
reports. Hospital mortality rates currently "are among the best-kept
secrets in American medicine" and remain "closely guarded," according to
USA Today.
The Web site will include information on whether
the 30-day mortality rates for the conditions at more than 4,000
hospitals nationwide are higher than, lower than or equal to the
national average.
CMS calculated the mortality rates based on heart
attack and heart failure patients who died for any reason within 30 days
of admission to hospitals between July 2005 and June 2006. According to
confidential data obtained by USA Today, only 17 of 4,477 hospitals had
mortality rates for heart attack that were lower than the national
average, and only 38 had mortality rates for heart failure that were
higher than the national average. However, the Web site will not include
specific information on mortality rates for the conditions at individual
hospitals.
"CMS has chosen to highlight a small percentage of
hospitals with the best and worst performance compared with the national
death rate" because of concerns about the "potential backlash from
hospitals fearful that a mediocre report card will drive patients away,"
USA Today reports. CMS also will not take corrective action against
hospitals with mortality rates for the conditions that are higher that
the national average, but agency officials hope that the Web site will
prompt such facilities to address the issue.
Michael Rapp, CMS director of quality measurement,
said, "If I'm running a hospital, and I see that I fall in a category
that's worse than 98% of hospitals, that's going to grab my attention."
Concerns
Some physicians and hospital officials have raised
concerns that the Web site fails to "give enough weight to how sick,
poor, rural or urban their patients are," USA Today reports. Steven
Nissen, a cardiologist at the
Cleveland Clinic,
said, "I feel strongly that the public has a right to see how hospitals
and physicians perform," adding, "It's got to be done carefully. If not,
it can backfire, and the whole system can fall down."
In addition, consumer advocates have raised
concerns about the lack of specific information on mortality rates for
heart attack and heart failure at individual hospitals. Minna Jung, an
expert on health care quality at the
Robert Wood Johnson
Foundation, said, "As a consumer, I would want to know if my
hospital has higher death rates than the hospital across town"
(Sternberg/DeBarros, USA Today, 5/23).
Increased Transparency
In related news,
USA Today
on Wednesday examined how increased "amounts of information on hospital
performance are a mouse-click away, thanks to the Internet's limitless
capacity and a bold consensus that transparency serves hospitals and
consumers." According to USA Today, although "not everyone is releasing
the same amount of information, the movement toward transparency is
spreading quickly" nationwide through efforts by the federal government,
some states, a number of hospitals and groups such as the
Hospital Quality
Alliance and
National Quality
Forum (Sternberg, USA Today, 5/23).
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