
Photo: Pia ChristensenA Health Journalism 2014 panel about hospital rankings included (left to right) Evan Marks of Healthgrades, Marshall Allen of ProPublica and John Santa, M.D., of Consumer Reports.
If you were at Health Journalism 2014, you might have heard that things got interesting on Saturday when journalists questioned panelists who represented hospital ranking services about their business practices.

Tony Leys
Tony Leys, a reporter for the Des Moines Register, was in the audience for “Hospital grading: Reporting on quality report cards” and asked Evan Marks, the executive vice president of informatics and strategy for Healthgrades, how much hospitals pay his organization to be allowed to advertise their ratings. Marks refused to answer the question.
After the panel, Leys pursued the question and got some details that all reporters should be aware of when they consider writing about hospital rankings, including some concrete data on how much hospitals are paying in “licensing fees” to ratings services. You might use his technique to find out how much some of your local hospitals are paying.
This is an issue we brought to the attention of several ratings agencies and the AHJC LinkedIn group as well as discussing it at the Atlanta meeting. The fact that hospitals are paying for ratings is the least of the harm; the ratings are arbitrary and commercially motivated and are designed to market to patients rather than to inform any objective choices. As with so many other things, it is also highly influenced by the advertisers in trade publications and obfuscated to deter real investigation. (Nov 06 post). Until some sunshine falls on this issue through consistent investigative reporting and follow up, the public will be deliberately misinformed.
One clarification: The hospitals are not paying for ratings; they are paying for the right to use the ratings in their marketing materials. I believe the HealthGrades executive called it a “licensing fee.” Nonetheless, consumers and reporters should be aware of how this process works and there should be transparency.