How Will Your Hospital Quality Ratings Affect Your Buying Patterns?

Do you know how your hospital stacks up against others in your regional area? Medicare does, and so do your patients.  The Hospital Compare program maintained by Medicare works to compare the quality of services of one hospital against another in order to determine which facilities should be rewarded with increased funding, and which should not.  This article will explore the implications of quality rating distributed by the Medicare Hospital Compare program, and steps hospitals can take to improve their rankings.

The impact of hospital quality ratings

Due to a number of recent changes in the healthcare industry (e.g. The Medical Excise Tax, EHR meaningful use, Value-Based Purchasing, etc.), it’s imperative that hospitals strive to keep their quality ratings high.  A hospital’s quality rating will not only directly impact the number of patients which choose to visit the facility, but will also affect its ability to receive payment from Medicare.  The Hospital Value-Based Purchasing Program enables Medicare to reward higher ranking hospitals with incentive payments.  The money allocated to fund this program will be taken from facilities with low rankings, as the total Medicare payment budget for 2013 is being reduced by 1%.  In other words, without high quality ratings, hospitals will suffer from reduced revenue, and therefore, will need to find ways to cut costs on staffing, facilities, equipment, or a combination of these in order to make ends meet.

It can therefore be expected that more highly ranked facilities will enjoy the luxury of purchasing state-of-the-art equipment, while those with poor ratings will be left behind.  This is a bit of a catch-22 when you consider that a hospital’s ability to maintain staff, quality equipment, and facilities will directly affect future quality ratings.  The objective, though, is that hospitals will experience higher levels of motivation to maximize the quality of patient care in exchange for financial incentives.

Factors involved in hospital quality ratings

The Medicare quality ratings for hospitals are based upon a number of factors including:

• How promptly a heart attack patient receives surgeries intended to prevent future incidents, such as Percutaneous Coronary Interventions (PCIs) in order to improve patient outcomes and reduce healthcare spending, overall.
• How frequently surgery patients receive the proper treatment for blood clot prevention as this can stop patients from developing potentially fatal blood clots and eliminate expensive complications.
• How regularly heart failure patients receive proper discharge instruction in order to eliminate future re-admittance into the hospital.
• The overall satisfaction of patients regarding their experience at the hospital.

Methods for improving hospital quality ratings

In order to improve your quality rating, it’s wise to take some time to analyze what is currently going on inside of your facility.  If heart attack patients are regularly re-admitted or post-op surgical complications occur frequently, Medicare will take notice.  Preventive treatments and a staff trained to deliver detailed follow-up care instructions will go a long way in boosting your ranking and budget.

Remember – your patient’s opinions count.  Many facilities with higher rankings are also embracing the practice of calling patients within 24 hours from discharge in order to follow-up on their overall health and well-being.  This is a great way to improve your patient’s satisfaction with your facility’s level of care.  Your staff should also be trained at regular intervals to anticipate and promptly respond to patient requests and to treat patients with dignity and respect in order to boost ratings.

By educating yourself on what is involved in Medicare hospital quality ratings, you will have an advantage in improving your ranking and the ability to continue buying equipment to provide the best care for your patients.