Using quality ratings in reporting on health care #AHCJ16

Lisa Aliferis

About Lisa Aliferis

Lisa Aliferis is the founding editor of KQED's State of Health blog. Since 2011, she's been writing and editing for the site. She has produced health stories for television and written a guide to the Affordable Care Act, especially for Californians. Her work has been honored for many awards. You can follow her on Twitter: @laliferis.

When I told a friend at Health Journalism 2016 that I would be attending and writing a short post on the “health ratings” session, she replied “I do not write about quality ratings!”

I’ve felt this same fatigue myself.

But the four panelists at the session, “Rating health care providers, when journalists measure quality” showed how ratings reports can be an important tool in covering either your local area or getting at national stories.

All the panelists agreed that no ranking system is perfect, but they are all steps toward much needed transparency in health care.

“Our feeling is consumers need good information to make informed decisions,” said Ben Harder, chief of health analysis with U.S. News and World Report. (Here’s the 2015-16 hospital survey.) “Patients can’t make good decisions without information.”

In health care, quality is literally a matter or life and death. An estimated 75,000 people a year die of hospital-acquired infections and, “errors in general are a huge cause of preventable deaths,” said Doris Peter, director of the Health Ratings Center for Consumer Reports. Some estimates show 400,000 deaths annually from preventable errors.

While Peter said consumers are her organization’s primary stake holder, Consumer Reports‘ end goal in publishing quality data, especially in hospital-acquired infections, is “really a tactic to get hospitals to change behavior.

Yes, there are big limitations in the data right now. Peters said she had four slides of challenges (that she did not show us) but said the big one is quality of the data itself. There’s underreporting of data by hospitals and providers, missing data and “no quality control around data,” she said.

Journalists can play a key role in demanding that governments release more quality data.

“The push should be for getting the raw data available, pushing the government, hospital, plans others” to make data available and ensure patient privacy at the same time, said Robert Krughoff, president of Consumers’ Checkbook.

Governments should not actually be doing the measures, Krughoff added.

“Government doesn’t put out measures that are easy for consumers to use. There’s too much political pushback. Get the data out there and let others do something with it.”

That’s exactly what Marshall Allen at ProPublica did in the Surgeon Scorecard project. His team worked with Medicare to release its data about eight common elective surgeries and then calculated surgical complication rates for doctors.

Allen urged anyone reporting on quality ratings to first read the methodology behind the ratings, because there is sure to be pushback from any provider or hospital journalists question about their ranking. Other questions reporters should ask:

  • Ask the doctor/hospital what they think about the rating/methodology
  • Ask about the provider’s own complication rate and how they measure it
  • If the provider does not report it, then why not?

“People who rate well by these are in favor” of ratings, he said, to laughter from the audience. “Call some who look good, to balance out those who don’t look good and shoot down the methodology.”

There’s a story coming soon. On April 21, CMS is releasing its Star rating for U.S. hospitals, the first time the government has issued a rating of practically every hospital in the country, says Ben Harder.

“You’re going to hear negative reactions from the hospital community,” he warned. A good step is to compare the CMS ratings against those from U.S. News and World Report and other ratings to see how they compare.  Ask pointed questions of the hospitals, he added.

Other resources for reporters looking at quality ratings include:

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