Robert FrombergEditor in Chief, HFMA
"Study Finds Widespread Lapses in Medical Quality for All Adults" ... "Hospital Quality Scores Improving"
How are we to reconcile these two news headlines? One reports on a study published this week in the New England Journal of Medicine that suggests half of Americans do not receive the care that is necessary according to their health status, and that this finding crosses sociodemographic boundaries. Predictably, this study got widespread media attention (although the finding about the percentage of Americans who do not receive necessary care had been published in 2003). The second headline refers to a study by the research firm Mathematica into the effect of Hospital Compare, CMS's tool for hospitals to report data on quality, which is shared with the public. The study showed that about 80% of hospitals included in the research reported significant improvement in at least one quality score since beginning to participate in the program.
The NEJM study was based on data collected in 1998-2000, while the Mathematica study was based on a 2005 survey.
It is tempting to say that these findings suggest that public reporting of quality data, as well as pay for performance, is showing signs of fixing the kind of quality lapses reported in the NEJM article. But is that true?
I asked the author of the Mathematica report, Mary Laschober, that question. She replied, “Our study was based on self-reports from hospital executives. They strongly are saying public reporting is having a positive effect on quality improvement efforts. There aren’t many studies available, but those that have been published also are showing a positive effect. These studies do, however, show hospitals still have room to improve quality.”
Do you believe that pay for performance will have an appreciable effect on healthcare quality?
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