HCR -- Compare Hospitals in Your Area

By John Ballard

Here are two links to bookmark and check back with since the information is likely to change. Consumer Reports and the Department of Health and Human Services track data which are becoming more detailed as the impact ot PPACA begins to take effect.

Many gaps remain and results are often wrapped in politically inoffensive language ("Better than National Averages" or "Same as National Averages") and I came across "State does not report" in too many places when looking up information about my area. But the heat is on and lights are beginning to shine in previously dark areas.

? Consumer Reports -- How we rate hospitals: the basics

Navigation is pretty straightforward. Look for tabs and toolbars taking you to data collections you never imagined might be available to you (some of which still are not, you will find).

? http://www.hospitalcompare.hhs.gov/

I'm putting this link here because navigation at CMS is NOT as user-friendly as I like. After using this resource to look up hospital results in my local area, however, I had a hard time getting rid of my zip code and personal results for the purpose of writing this post. I suppose that's a good feature for other old people but my experience is that most users, old or not, would rather get an empty page and state over when using resources like this.

The Hospital Compare website was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (DHHS), along with the Hospital Quality Alliance (HQA). The HQA is a public-private collaboration established to promote reporting on hospital quality of care. The HQA consists of organizations that represent consumers, hospitals, doctors and nurses, employers, accrediting organizations, and Federal agencies. The information on this website can be used by any patients needing hospital care.

Hospital Compare displays rates for Process of Care measures that show whether or not hospitals provide some of the care that is recommended for patients being treated for a heart attack, heart failure, pneumonia, asthma (children only) or patients having surgery. Hospitals voluntarily submit data from medical records about the treatments their patients receive for these conditions. The data include patients with Medicare, those enrolled in Medicare health plans, and those who don�t have Medicare.

You get the idea.
Wouldn't want to step on any private sector toes, you know, just because curious taxpayers want more transparency about where their money goes.

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While I'm housekeeping, here's yet another comparison post with timely links by Maggie Mahar. This is where I got the links above, this being open season for private insurance companies to go hunting for new Medicare customers.

? Health Insurers in the Spotlight Consumer Reports Publishes Quality Rankings; HHS Makes Rate Increases Public; They Can Run, But...

Excerpt here...

Why does the Kaiser plan in Georgia rank only 52nd nationwide while securing first place in the state? In general, Consumer Reports Magazine points out, insurance plans in the South and some parts of the West don�t perform as well in national rankings as insurers in the NorthEast, particularly New England: �Eighteen of the 50 top-ranked private plans are in this compact six-state region,� the magazine observes. �Both Aetna and the �Blues� had New England plans ranked in the top 100, while many of the same insurers' plans in southern and western states ranked near the bottom of the list.�

This may be because some states have fewer resources, poorer patients, less efficient hospitals, more "safety-net" hospitals that are struggling to stay afloat, fewer physicians, and a medical culture where providers are less likely to collaborate to co-ordinate care. Thus, a Kaiser plan in Georgia that ranks 52nd nationally, but 1st in the state, may well be delivering the best care possible under less than ideal circumstances.

Medicare also has found enormous geographic variations in the quality of care nationwide. Medicare uses a 5-star system to rate Medicare Advantage plans and in 2010 it looked at the plans state by state, reporting that, at the top of the ladder more than half of Medicare Advantage enrollees in California, Massachusetts and Hawaii were in plans with four or more stars. In addition, �California and Pennsylvania accounted for nearly half of enrollees in plans that scored 4 or more stars."

But as the map below reveals, in some states a senior would be hard-pressed to find a 4-star insurer. In dark blue states at least 45 percent of the state�s Advantage members are enrolled in plans that received at 4 stars or more, but in states painted dark orange, such as Louisiana, �0 percent� are enrolled in a plan that managed to garner 4 stars on a 5-star scale. Texas does only a little better: 2 percent of Advantage seniors are in 4-star plans. (In fairness, it should be said that roughly 40 percent of Advantage plans were not ranked because they didn�t have enough quality data to provide a basis for calculating a score. But if an insurer doesn�t collect quality data�or if the plan is too new to have much data�chances are this is not the plan you want.)

?The Quiet Health-Care Revolution by Tom Main and Adrian Slywotzky in The Atlantic, November 2011

Long but inspiring article. Makes me not lose hope for the future.
Snips here... 

THE CAREMORE STORY begins almost two decades ago, with a man named Sheldon Zinberg, a gastroenterologist who was deeply concerned about the changing economics of health care in Southern California. There, as in other U.S. markets, health-maintenance organizations, or HMOs, had come to dominate the landscape. The theory behind HMOs was attractive: �managed care� was supposed to coordinate and guide treatments in order to maximize both patient wellbeing and economic sustainability. But under pressure from corporate health-insurance sponsors and government agencies (as well as investors seeking profits), HMOs increasingly focused on reducing costs by any means necessary�including short-term fixes that often led to worse patient outcomes and, in the long run, even higher medical expenses. Patients were suffering, doctors were getting squeezed, and costs, after falling for a time, were soon spiraling upward again.

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One of CareMore�s critical insights was the application of an old systems-management principle first developed at Bell Labs in the 1930s and refined by the management guru W. Edwards Deming in the 1950s: you can fix a problem at step one for $1, or fix it at step 10 for $30. The American health-care system is repair-centric, not prevention-centric. We wait for train wrecks and then clean up the damage. What would happen if we prevented the train wrecks in the first place? The doctors at CareMore decided to find out.

An early discovery was that CareMore�s elderly patients failed to show up for as many as one-third of their doctor appointments. As Charles Holzner, one of Zinberg�s initial partners at CareMore and now a senior physician with the company, explains, �About one in three of the elderly people we were taking care of were home by themselves. They�d outlived their family resources, they couldn�t drive, and their kids lived out of town. So when they got sick, they ended up calling 911. And when it came to routine doctor visits, they sometimes just couldn�t make it at all.�

CareMore�s unconventional solution to the problem was to provide transportation, at no charge, to get patients to their medical appointments. Local car-service companies were happy to have the business, and while the transportation cost money, it ultimately saved a lot more. Increased regularity and consistency of medical care meant that many simple problems were recognized and treated in their early stages: complications were avoided, and rates of hospitalization and nursing-home admittance began to fall.

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...When he launched CareMore in 1993, Sheldon Zinberg told his partners, �If you put people before profit, everyone profits.� During its first four years, operating as a more-or-less conventional health-care provider, CareMore accumulated losses of about $11 million. But as the system of Medicare-financed, coordinated care Zinberg had initially envisioned came into being, the company turned the corner, showing a $24 million profit in 2000. It has remained solidly in the black ever since.

The economic logic behind CareMore is unusual. Every additional service it provides costs money, and the professionals at CareMore have to take on tasks and responsibilities that physicians don�t traditionally assume. CareMore employs more staffers per patient than other companies, and they spend more time with patients and their families than is typical. But every dollar CareMore spends saves multiple dollars down the line, resulting in those member costs that are 18 percent below the industry average.

Did that just read more staffers per patient than other companies ???
Huh?
What was that?

Did somebody mention JOBS???